Ambiguity in bone tissue characteristics as presented in studies on dental implant planning and placement: a systematic review.
OBJECTIVE
To survey definitions of bone tissue characteristics and methods of assessing them in studies of dental implant planning and placement.


METHODS
Three databases were searched using specified indexing terms. Three reviewers selected from the titles and retrieved abstracts in accordance with inclusion and exclusion criteria. Descriptions of bone tissue characteristics (bone quality, density and quantity) used before or during dental implant placement were searched for and categorized.


RESULTS
The search yielded 488 titles. One hundred and fort-nine publications were selected and read in full text. One hundred and eight were considered relevant. There were many different definitions and classification systems for bone tissue characteristics and examination protocols. Approximately two-third of the included publications reported the Lekholm & Zarb classification system for bone quality and quantity. However, only four studies implemented the Lekholm & Zarb system as originally proposed. A few publications described bone quality in accordance with the Misch or Trisi and Rao classifications systems. Assessment methods were often described only briefly (or not at all in one-fifth of the publications). Only one study presented the diagnostic accuracy of the assessment method, while only two presented observer performance.


CONCLUSIONS
The differing definitions and classification systems applied to dental implant planning and placement make it impossible to compare the results of various studies, particularly with respect to whether bone quality or quantity affect treatment outcomes. A consistent classification system for bone tissue characteristics is needed, as well as an appropriate description of bone tissue assessment methods, their diagnostic accuracy and observer performance.
Department of Oral Medicine, School of Dentistry, Federal University of Goiás, Goiás, Brazil. rejanefrr@gmail.com
Rejane Faria
RF
Ribeiro-Rotta
Christina
C
Lindh
Andrea Castro
AC
Pereira
Madeleine
M
Rohlin
D015519:Bone Density / Q000502:physiology*; D001862:Bone Resorption / Q000145:classification; D003758:Dental Implantation, Endosseous; D003952:Diagnostic Imaging; D006801:Humans; D007568:Jaw / Q000473:pathology*; D007571:Jaw Diseases / Q000145:classification; D010347:Patient Care Planning