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Safer and faster: evaluation of a dental implant checklist
Johannes Raphael Kupka1,2, Franck Renouard3, Keyvan Sagheb4
1Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Center of the Johannes Gutenberg-University, Augustusplatz 2, Mainz, 55131, Germany. johanneskupka@web.de.
Objective:
Systematic safety approaches, remain largely unevaluated in dental implantology. This prospective interventional study aimed to evaluate the impact of a structured surgical safety checklist on clinical incidents and organizational efficiency in dental implant surgery.
Methods:
A before-and-after study design was implemented at a high-volume center, documenting 124 consecutive dental implant surgeries (61 without, 63 with checklist) using a previously by Kupka et al. developed safety checklist. The primary endpoint was the occurrence of incidents divided into clinical deviations and workflow disruptions; the secondary endpoint was procedure duration.
Results:
Checklist implementation resulted in a statistically significant reduction in mean surgery duration. Mean operative time decreased from 75.4 min (SD 31.9) to 60.3 min (SD 31.4), representing a median decrease: 15.0 min (p < 0.01). The rate of surgeries with at least one incident decreased from 36.1% (22/61) to 23.8% (15/63), which was not statistically significant (p = 0.170). However, clinical deviations dropped significantly from 13.1% to 0.0% (p = 0.003).
Conclusion:
To our knowledge, this is the first study investigating checklist effects on incidents and operating time in implant dentistry, and the largest case number in oral surgery. Introducing a surgical checklist significantly improved efficiency by reducing procedure duration. While the reduction in overall incidents was not statistically significant, the elimination of clinical deviations suggests a safety benefit. Structured checklists might be a valuable tool to enhance patient safety and operational workflow in elective implant surgery.
