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

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Ronald E Jung, Bilal Al-Nawas, Mauricio Araujo, Gustavo Avila-Ortiz, Stephen Barter, Nadine Brodala, Vivianne Chappuis, Bo Chen, Andre De Souza, Ricardo Faria Almeida, Stefan Fickl, Gary Finelle, Jeffrey Ganeles, Hadi Gholami, Christoph Hammerle, Simon Jensen, Asbjørn Jokstad, Hideaki Katsuyama, Johannes Kleinheinz, Chatchai Kunavisarut & 12 others Nikos Mardas, Alberto Monje, Panos Papaspyridakos, Michael Payer, Eik Schiegnitz, Ralf Smeets, Martina Stefanini, Christiaan Ten Bruggenkate, Konstantinos Vazouras, Hans-Peter Weber, Dieter Weingart, Péter Windisch

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
JournalClinical Oral Implants Research
Issue numberS16
Pages (from-to)69-77
Number of pages9
Publication statusPublished - 2018
EventITI Consensus Conference - Amsterdam, Netherlands
Duration: 17 Apr 201819 Apr 2018
Conference number: 6


ConferenceITI Consensus Conference

    Research areas

  • Consensus, Dental Implantation, Endosseous, Dental Implants, Dental Prosthesis Design, Dental Restoration Failure, Diphosphonates/adverse effects, Humans, Jaw, Edentulous, Partially/rehabilitation, Osteoporosis/complications, Patient Reported Outcome Measures, Proton Pump Inhibitors/adverse effects, Radiography, Dental, Serotonin Uptake Inhibitors/adverse effects, Survival Analysis, Systematic Reviews as Topic

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