Comparison of dental implant systems: quality of clinical evidence and prediction of 5-year survival.
OBJECTIVE
This literature review was conducted to evaluate the quality of current evidence of clinical performance provided by American Dental Association-certified dental implant manufacturers and manufacturers with strong market penetration in the United States. The study also compared the clinical performance of different dental implant systems.


METHODS
A letter was sent to 6 implant manufacturers requesting 10 references each that validated the manufacturer's implant system in a variety of clinical applications. References were reviewed and classified relative to strength of evidence. Data extraction was then performed. Comparisons of implant survival data from 5-year studies were made, and data were pooled to establish an overall 5-year survival rate with confidence intervals (CIs).


RESULTS
A total of 69 references were provided by the 6 implant manufacturers (Astra Tech, Centerpulse, Dentsply/Friadent, Implant Innovations, Nobel Biocare, and Straumann) but only 59 articles were available for review. Of those references, most were level-4 (case series) or level-5 (expert opinion) articles. Five-year survival data were extracted from 17 articles demonstrating overlap of CIs from the weighted average of the pooled data from each specific manufacturer; substantial equivalence of all implant systems was demonstrated based upon survival alone at 5 years. When all data were pooled, the 5-year survival rate of 96% (CI: 93% to 98%) was observed for a total of 7,398 implants.


CONCLUSIONS
No obvious differences in implant survival were observed when comparing implant systems.


CONCLUSIONS
The evidence supporting implant therapy is generally derived from level-4 case series rather than higher-level cohort or controlled clinical trials. Articles that directly compared different implant systems were not found. Five-year implant survival rates easily exceeded the minimums recommended by the American Dental Association certification program. (More than 50 references.)
Mayo Medical School, Division of Prosthodontics, Mayo Clinic, Rochester, Minnesota 55905, USA. seeckert@mayo.edu
Steven E
SE
Eckert
Yong-Geun
YG
Choi
Andrés R
AR
Sánchez
Sreenivas
S
Koka
D015706:Bibliometrics; D015921:Dental Implants / Q000592:standards* / Q000706:statistics & numerical data; D018865:Dental Research / Q000592:standards / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine / Q000592:standards / Q000706:statistics & numerical data; D005544:Forecasting; D006801:Humans; D007221:Industry; D012107:Research Design / Q000592:standards / Q000706:statistics & numerical data; D016019:Survival Analysis; D014481:United States
D015921:Dental Implants