The primary function of a dental implant is to act as an abutment for a prosthetic device, similar to a natural tooth root and crown. Any success criteria, therefore, must include first and foremost support of a functional prosthesis. In addition, although clinical criteria for prosthetic success are beyond the scope of this article, patient satisfaction with the esthetic appearance of the implant restoration is necessary in clinical practice. The restoring dentist designs and fabricates a prosthesis similar to one supported by a tooth, and as such often evaluates and treats the dental implant similarly to a natural tooth. Yet, fundamental differences in the support system between these entities should be recognized. The purpose of this article is to use a few indices developed for natural teeth as an index that is specific for endosteal root-form implants. This article is also intended to update and upgrade what is purported to be implant success, implant survival, and implant failure. The Health Scale presented in this article was developed and accepted by the International Congress of Oral Implantologists Consensus Conference for Implant Success in Pisa, Italy, October 2007.

Background: Multiple variables have been shown to affect early marginal bone loss (MBL). Among them, the location of the microgap with respect to the alveolar bone crest, occlusion, and use of a polished collar have traditionally been investigated as major contributory factors for this early remodeling. Recently, soft tissue thickness has also been investigated as a possible factor influencing this phenomenon. Hence, this study aims to further evaluate the influence of soft tissue thickness on early MBL around dental implants.Methods: Electronic and manual literature searches were performed by two independent reviewers in several databases, including Medline, EMBASE, and Cochrane Oral Health Group Trials Register, for articles up to May 2015 reporting soft tissue thickness at time of implant placement and MBL with ≥12‐month follow‐up. In addition, random effects meta‐analyses of selected studies were applied to analyze the weighted mean difference (WMD) of MBL between groups of thick and thin peri‐implant soft tissue. Metaregression was conducted to investigate any potential influences of confounding factors, i.e., platform switching design, cement‐/screw‐retained restoration, and flapped/flapless surgical techniques.Results: Eight articles were included in the systematic review, and five were included in the quantitative synthesis and meta‐analyzed to examine the influence of tissue thickness on early MBL. Meta‐analysis for the comparison of MBL among selected studies showed a WMD of −0.80 mm (95% confidence interval −1.18 to −0.42 mm) (P <0.0001), favoring the thick tissue group. Metaregression of the selected studies failed to demonstrate an association among MBL and confounding factors.Conclusion: The current study demonstrates that implants placed with an initially thicker peri‐implant soft tissue have less radiographic MBL in the short term.

Background: Implant‐supported restorations have become the most popular therapeutic option for professionals and patients for the treatment of total and partial edentulism. When implants are placed in an ideal position, with adequate prosthetic loading and proper maintenance, they can have success rates >90% over 15 years of function. Implants may be considered a better therapeutic alternative than performing more extensive conservative procedures in an attempt to save or maintain a compromised tooth. Inadequate indication for tooth extraction has resulted in the sacrifice of many sound savable teeth. This article presents a chart that can assist clinicians in making the right decision when they are deciding which route to take.Methods: Articles published in peer‐reviewed English journals were selected using several scientific databases and subsequently reviewed. Book sources were also searched. Individual tooth‐ and patient‐related features were thoroughly analyzed, particularly when determining if a tooth should be indicated for extraction.Results: A color‐based decision‐making chart with six different levels, including several factors, was developed based upon available scientific literature. The rationale for including these factors is provided, and its interpretation is justified with literature support.Conclusion: The decision‐making chart provided may serve as a reference guide for dentists when making the decision to save or extract a compromised tooth.

Purpose: The aim of this study was to establish an objective criterion in terms of marginal bone level (MBL) to know the prognosis of an implant.Materials and Methods: A group of 176 patients in whom 590 implants were placed were included in this retrospective study. Patients older than 18 years, presenting either Kennedy class I or II edentulous section, or totally edentulous at least in one of the dental arches were included in this study. Those with any type of disturbance able to alter bone metabolism or with nontreated periodontal disease were excluded. Data on radiographic MBL at loading, 6 and 18 months later, age, gender, smoking habits, history of periodontitis, bone substratum, implant, and prosthetic features were recorded. Nonparametric receiver operating curves (ROC) were constructed for the MBL at 18 months in order to establish a distinction among high bone loser (HBL) and low bone loser (LBL) implants. Differences as a function of main variables were also determined, particularly abutment height and periodontal disease.Results: HBL implants lost at least 0.48 mm of MBL 6 months after loading; they reached at least 2 mm of MBL 18 months after loading. MBL rate followed a nonlinear trend, except in implants restored over long prosthetic abutments and in patients with history of severe periodontitis; in whom the rate of MBL over the time was nearly zero.Conclusion: Implants that lose more than 0.5 mm of marginal bone 6 months after loading are at great risk of not being radiographically successful anymore. Therefore, 0.5 mm of MBL is proposed as a distinctive and objective criterion of success in Implant Dentistry within a 6‐month follow‐up period. A prosthetic abutment height ≥2 mm resulted the most protective factor in the peri‐implant bone maintenance.