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.)
Eckert
Steven E
SE
Mayo Medical School, Division of Prosthodontics, Mayo Clinic, Rochester, Minnesota 55905, USA. seeckert@mayo.edu
Choi
Yong-Geun
YG
Sánchez
Andrés R
AR
Koka
Sreenivas
S
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