On long-term maintenance of the osseointegrated response

Every oral implant system must be backed up by controlled reporting of the clinical outcome. Look-alike implants do not necessarily show similar long-term clinical results. Osseointegration of an implant is not the same as clinical success, as secondary loss of osseointegration may be a frequent problem with respect to certain biomaterials as well as implant designs. For instance, with respect to solid cylinders, there is no published report documenting that such implants ever establish a steady state with respect to bone height. A continuous bone loss of half a millimetre or more will inevitably jeopardise the outcome of the implant over follow-up times of five to ten years. The author suggests a new way of reporting the outcome of oral implants in a four field table with Success, Survival, Unaccounted for and Failure categories. Success applies to those implants that meet with specific Success criteria. Survival are those implants that are still in the jaw of the patient but where criteria for success or failure are not met. Unaccounted for are implants in patients who dropped out from the study for one reason or the other including patient death. Failures are those implants which have been removed from the jaw or where absolute failure criteria such as implant mobility or therapy-resistant pain apply.