Group 1 ITI Consensus Report: The influence of implant length and design and medications on clinical and patient-reported outcomes

R.E. Jung, B. Al-Nawas, M. Araujo, G. Avila-Ortiz, S. Barter, N. Brodala, V. Chappuis, B. Chen, A. De Souza, R.F. Almeida, S. Fickl, G. Finelle, J. Ganeles, H. Gholami, C. Hammerle, S. Jensen, A. Jokstad, H. Katsuyama, J. Kleinheinz, C. KunavisarutN. Mardas, A. Monje, P. Papaspyridakos, M. Payer, E. Schiegnitz, R. Smeets, M. Stefanini, C. ten Bruggenkate, K. Vazouras, H.P. Weber, D. Weingart, P. Windisch

Research output: Contribution to JournalReview articleAcademicpeer-review

Abstract

Objectives: The aim of Working Group 1 was to address the influence of different local (implant length, diameter, and design) and systemic (medications) factors on clinical, radiographic, and patient-reported outcomes in implant dentistry. Focused questions on (a) short posterior dental implants (≤6 mm), (b) narrow diameter implants, (c) implant design (tapered compared to a non-tapered implant design), and (d) medication-related dental implant failures were addressed. Materials and methods: Four systematic reviews were prepared in advance of the Consensus Conference and were discussed among the participants of Group 1. Consensus statements, clinical recommendations, and recommendations for future research were based on structured group discussions until consensus was reached among the entire expert Group 1. The statements were then presented and accepted following further discussion and modifications as required by the plenary. Results: Short implants (≤6 mm) revealed a survival rate ranging from 86.7% to 100%, whereas standard implant survival rate ranged from 95% to 100% with a follow-up from 1 to 5 years. Short implants demonstrated a higher variability and a higher Risk Ratio [RR: 1.24 (95% CI: 0.63, 2.44, p = 0.54)] for failure compared to standard implants. Narrow diameter implants (NDI) have been classified into three categories: Category 1: Implants with a diameter of <2.5 mm (“Mini-implants”); Category 2: Implants with a diameter of 2.5 mm to <3.3 mm; Category 3: Implants with a diameter of 3.3 mm to 3.5 mm. Mean survival rates were 94.7 ± 5%, 97.3 ± 5% and 97.7 ± 2.3% for category 1, 2 and 3. Tapered versus non-tapered implants demonstrated only insignificant differences regarding clinical, radiographic, and patient-reported outcomes. The intake of certain selective serotonin reuptake inhibitors and proton pump inhibitors is associated with a statistically significant increased implant failure rate. The intake of bisphosphonates related to the treatment of osteoporosis was not associated with an increased implant failure rate. Conclusions: It is concluded that short implants (≤6 mm) are a valid option in situations of reduced bone height to avoid possible morbidity associated with augmentation procedures; however, they reveal a higher variability and lower predictability in survival rates. Narrow diameter implants with diameters of 2.5 mm and more demonstrated no difference in implant survival rates compared to standard diameter implants. In contrast, it is concluded that narrow diameter implants with diameters of less than 2.5 mm exhibited lower survival rates compared to standard diameter implants. It is further concluded that there are no differences between tapered versus non-tapered dental implants. Certain medications such as selective serotonin reuptake inhibitors and proton pump inhibitors showed an association with a higher implant failure rate.
Original languageEnglish
Pages (from-to)69-77
JournalClinical Oral Implants Research
Volume29
Issue numberS16
DOIs
Publication statusPublished - 2018

Bibliographical note

In special issue: Proceedings of the Sixth ITI Consensus Conference.

Funding

2Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany 3Department of Dentistry, Universidade Estadual de Maringa, Maringa, Brazil 4Department of Periodontics, University of Iowa College of Dentistry, Iowa City, Iowa 5Centre for Oral Clinical Research, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK 6Private Practice, Chicago, Illinois 7Department of Oral Surgery and Stomatology, University of Bern, Bern, Switzerland 8Department of Oral Implantology, Peking University School and Hospital of Stomatology, Beijing, China 9Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Massachusetts 10University of Porto, Porto, Portugal 11Complutense University of Madrid, Madrid, Spain 12Department of Periodontology, University of WD?rzburg, Germany and Private Office, Nuremberg/Fuerth, Germany 13Gary Finelle, Private Practice, Paris, France 14South Florida Center for Periodontics and Implant Dentistry, Boca Raton, Florida 15Nova Southeastern University, Fort Lauderdale, Florida 16Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark 17Clinical Dentistry, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway 18Prosthodontics, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada 19Private Practice, MM Dental Clinic, Tokyo, Japan 20Tokyo Medical and Dental University, Tokyo, Japan 21Department of Cranio‐Maxillofacial Surgery, University Hospital MD?nster, MD?nster, Germany 22Advanced General Dentistry Department, Faculty of Dentistry, Mahidol University, Bangkok, Thailand 23Adult Oral Health‐Periodontology, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK 24Department of Periodontology, International University of Catalonia, Barcelona, Spain This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2018 The Authors. Clinical Oral Implants Research Published by John Wiley & Sons Ltd.

FundersFunder number
4Department
Copenhagen University Hospital
International University of Catalonia
Medical and Dental University
University of WD?rzburg
City, University of London
Tufts University School of Medicine
University of Iowa
Universität Bern
Queen Mary University of London
Faculty of Dentistry, University of Toronto
Johannes Gutenberg-Universität Mainz
Mahidol University
Barts and The London School of Medicine and Dentistry
School of Stomatology, Peking University

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