Advances in implant therapy in North America: Improved outcomes and application in the compromised dentition

Advances in dental implant therapy have strengthened our understanding of the management of the implant-soft tissue interface, with site-specific implications ranging from marginal tissue management and esthetics to immediate placement and restoration, and extend to patient-level implications of systemic conditions. The advancements in implant therapy have placed an increased emphasis on patient-centered outcomes. In this paper, the following conclusions can be drawn: improvements in both esthetics and long-term maintenance have been guided by the study of the marginal peri-implant tissues leading to innovations in implant design along the implant-abutment interface. Patient expectations for simple and realistic time intervals for treatment have promoted the use of immediate implant placement and restoration. The expansion of implant therapy offers implant options for patients with medical conditions, with one in particular, diabetes mellitus a focus of this paper. Studies on patients with diabetes are supporting the development of evidence-based treatment considerations with broader application and greater benefits for the use of implant therapy across a larger patient population. This paper is not intended to offer a comprehensive review, but offers a representative review of some of the many contributions of USA and North American clinicians to the global scientific dialogue that has guided the development of dental implant therapy.