title: Improvements in implant dentistry over the last decade: comparison of survival and complication rates in older and newer publications.
abstract: OBJECTIVE
  The objective of this systematic review was to assess and compare the survival and complication rates of implant-supported prostheses reported in studies published in the year 2000 and before, to those reported in studies published after the year 2000.
  
  
  METHODS
  Three electronic searches complemented by manual searching were conducted to identify 139 prospective and retrospective studies on implant-supported prostheses. The included studies were divided in two groups: a group of 31 older studies published in the year 2000 or before, and a group of 108 newer studies published after the year 2000. Survival and complication rates were calculated using Poisson regression models, and multivariable robust Poisson regression was used to formally compare the outcomes of older and newer studies.
  
  
  RESULTS
  The 5-year survival rate of implant-supported prostheses was significantly increased in newer studies compared with older studies. The overall survival rate increased from 93.5% to 97.1%. The survival rate for cemented prostheses increased from 95.2% to 97.9%; for screw-retained reconstruction, from 77.6% to 96.8%; for implant-supported single crowns, from 92.6% to 97.2%; and for implant-supported fixed dental prostheses (FDPs), from 93.5% to 96.4%. The incidence of esthetic complications decreased in more recent studies compared with older ones, but the incidence of biologic complications was similar. The results for technical complications were inconsistent. There was a significant reduction in abutment or screw loosening by implant-supported FDPs. On the other hand, the total number of technical complications and the incidence of fracture of the veneering material was significantly increased in the newer studies. To explain the increased rate of complications, minor complications are probably reported in more detail in the newer publications.
  
  
  CONCLUSIONS
  The results of the present systematic review demonstrated a positive learning curve in implant dentistry, represented in higher survival rates and lower complication rates reported in more recent clinical studies. The incidence of esthetic, biologic, and technical complications, however, is still high. Hence, it is important to identify these complications and their etiology to make implant treatment even more predictable in the future.
authors.forename: Bjarni E
authors.initials: BE
authors.lastname: Pjetursson
authors.forename: Asgeir G
authors.initials: AG
authors.lastname: Asgeirsson
authors.forename: Marcel
authors.initials: M
authors.lastname: Zwahlen
authors.forename: Irena
authors.initials: I
authors.lastname: Sailer
mesh_terms: D015706:Bibliometrics; D001863:Bone Screws; D003442:Crowns; D003738:Dental Cements; D019250:Dental Implants, Single-Tooth / Q000009:adverse effects / Q000706:statistics & numerical data / Q000639:trends; D017268:Dental Prosthesis Retention / Q000706:statistics & numerical data; D019094:Dental Prosthesis, Implant-Supported / Q000009:adverse effects / Q000706:statistics & numerical data* / Q000639:trends; D019232:Dental Restoration Failure / Q000706:statistics & numerical data*; D003824:Denture, Complete / Q000706:statistics & numerical data; D006801:Humans; D059032:Learning Curve; D011446:Prospective Studies; D012044:Regression Analysis; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D003738:Dental Cements