European Association for Osseointegration Delphi study on the trends in Implant Dentistry in Europe for the year 2030.

OBJECTIVES: To assess the potential trends for the year 2030 in dental implant dentistry in Europe using the Delphi methodology. MATERIAL AND METHODS: A steering committee and a management team of experts in implant dentistry were created and validated a questionnaire including 60 questions, divided in eight topics. The survey was conducted in two rounds using an anonymous questionnaire, which provided the participants in the second round with the results of the first. Each question had three possible answers, and the results were expressed as percentages. RESULTS: A total of 138 experts were invited to participate in the survey. From all the invited experts, 52 answered in both the first and second rounds. Three different consensus categories were established based on the percentage of agreement: no consensus (<65%); moderate consensus (65%-85%); and high consensus (≥86%). Within the topic categories, a consensus was reached (mainly moderate consensus) for the majority of questions discussed among experts during a face to face consensus meeting. However, consensus was not reached for a small number of questions/topics. CONCLUSIONS: About 82% of the questions reached consensus. The consensus points towards a lower number of implants to replace chewing units, with implants surfaces made of bioactive materials with reduced micro-roughness using mainly customized abutments with polished surfaces and an internal implant-abutment connection (85%). CBCT-3D technologies will be the main tool for pre-surgical implant placement diagnosis together with direct digital restorative workflows. There will be an increase in the incidence of peri-implantitis, although there will be more efficient interventions its treatment and prevention.

What is the optimal number of implants for fixed reconstructions: a systematic review.

OBJECTIVES: To assess the 5-year and 10-year survival and complication rates of implant-supported fixed reconstructions in partially and totally edentulous patients with regard to the optimal number and distribution of dental implants. MATERIAL AND METHODS: This review was designed as a systematic review of the literature. A search strategy was developed and executed using an electronic and selective hand search for English-language articles in Dental Journals limited to human clinical trials. Search terms were grouped into categories for "problem" - "intervention" - "outcome". For articles retrieved by this search, abstracts were screened by two reviewers based on the inclusion criteria. Selected articles were then obtained in full texts. Finally, the selection based on inclusion/exclusion criteria was repeated for the full-text articles. RESULTS: Of the 210 titles retrieved by the search, 51 were selected for full-text review based on the information given in the abstract. From the full-text articles, a total of nine studies were included for this systematic review. In meta-analysis, prosthetic survival rates over 5 and 10 years for partial Fixed Dental Prostheses (FDPs) on two to four implants were estimated as 98.9% (95% CI: 98.5-99.2%) and as 97.8% (95% CI: 96.9-98.4%) respectively. A survival rate for maxillary Full-Arch Fixed Dental Prostheses (FAFDPs) on four to six implants after 5 years was assessed as 97.5% (95% CI: 94.1-98.9%) and a survival rate after 10 years as 95.0% (95% CI: 88.5-97.9%). The result for the survival rates in case of mandibular FAFDPs on four to six implants after 5 years was 97.9% (95% CI: 96.3-98.8%) and after 10 years 95.9% (95% CI: 92.8-97.7%). Specific implant-to-replaced-unit-ratios were not available in any of the studies. CONCLUSION: For implant-supported FAFDPs, using 4-6 implants is a well-documented treatment option with high estimated 5-year survival of the construction. It is unclear whether three implants for supporting a FAFDP will achieve similar survival rates. The RCTs needed that report implant-to-replaced-units-ratios for partial FDPs and include 3 vs. 4-6 implants for supporting a FAFDP in the mandible.