The evidence library: key studies on full-mouth implants, in plain English

How we chose the studies

We started with the papers dentists themselves use to explain full-arch treatment: systematic reviews and meta-analyses, the 2017 World Workshop definitions of gum disease around implants, Cochrane reviews, and the handful of cohort studies that have followed patients for 10, 15 or 20 years. We added classic papers where they explain why treatment is done the way it is, such as the first Swedish reports from the 1970s and 1980s.

For every paper we read the abstract on PubMed before writing a word, and every number on a card is copied from that abstract. Where a paper has no abstract on PubMed, we describe it without quoting figures. You can check each one through the PMID link.

How to read a study card

Each card shows the study design, its size and how long patients were followed. Three things are worth looking at first:

• Survival or success? Survival only means the implant or bridge is still there. Success adds conditions such as no pain, no infection and limited bone loss, so success rates are always lower.
• Implant or bridge? A bridge can keep working after one implant under it is lost, so prosthesis survival is often higher than implant survival.
• Who was lost along the way? Long studies lose patients to illness, death or moving away. If those people are left out, the remaining figures can look better than reality.

The study design matters too. A systematic review pools many studies, a randomised controlled trial is the fairest way to compare two treatments, and a cohort study follows one group over time. A single clinic's case series sits lower on that ladder, however impressive its numbers.

The studies, by topic

Use the buttons to show one topic at a time. The numbers behind the charts on our data pages come from these cards.

117 studies

Long-term survival

Long-term survival Clinical monograph · single Swedish centre · 10-year experience

Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period.

Brånemark PI, Hansson BO, Adell R, Breine U, Lindström J, Hallén O, Ohman A. Scand J Plast Reconstr Surg Suppl 1977. PMID 356184

What it found: The first long report on screw-shaped titanium implants that fuse with jaw bone, used to hold fixed teeth in people with no teeth. It describes the method that later became the template for modern full-arch treatment.

What it means for you: Fixed teeth on a handful of implants in a toothless jaw are not a new idea: the approach has been followed in patients since the 1960s.

Limits: A historical monograph with no PubMed abstract. Implants, surfaces and techniques have changed a great deal since, so its numbers are not quoted here.

Long-term survival Consecutive case series · 371 patients, 410 jaws, 2,768 implants · 1965 to 1980

A 15-year study of osseointegrated implants in the treatment of the edentulous jaw.

Adell R, Lekholm U, Rockler B, Brånemark PI. Int J Oral Surg 1981. PMID 6809663

What it found: In the group treated with the standardised method (130 jaws, 895 implants, 5 to 9 years of observation), 81% of upper-jaw and 91% of lower-jaw implants stayed stable, and the bridges were continuously stable in 89% of upper and 100% of lower jaws. Bone loss averaged 1.5 mm during healing and the first year, then 0.1 mm a year.

What it means for you: The upper jaw was harder to treat than the lower from the start, and a small amount of bone change in the first year is expected.

Limits: Early machined-surface implants and removable-by-the-dentist bridges; one research group; not directly comparable with modern rough-surface implants.

Long-term survival Review with proposed criteria

The long-term efficacy of currently used dental implants: a review and proposed criteria of success.

Albrektsson T, Zarb G, Worthington P, Eriksson AR. Int J Oral Maxillofac Implants 1986. PMID 3527955

What it found: Proposed a set of criteria for calling an implant a 'success' rather than simply 'still there': for example no mobility, no persistent pain or infection, no dark zone around the implant on X-ray and only limited bone loss after the first year.

What it means for you: When a study reports 'success', ask which definition it used. Success is a stricter test than survival.

Limits: No PubMed abstract, so the exact thresholds are not quoted here. Later consensus work refined these criteria.

Long-term survival Systematic review · RCTs and prospective studies, rough-surface implants · at least 5 years

Success criteria in implant dentistry: a systematic review.

Papaspyridakos P, Chen CJ, Singh M, Weber HP, Gallucci GO. J Dent Res 2012. PMID 22157097

What it found: The criteria most often used for success at implant level were mobility, pain, a dark line around the implant on X-ray and bone loss of more than 1.5 mm. Soft-tissue success looked at pus and bleeding; prosthetic success at technical problems, function and appearance; patient success at discomfort, numbness, satisfaction with appearance and ability to chew and taste.

What it means for you: A treatment can 'survive' and still not be a full success for you. The authors argue the implant and the teeth on it should be judged together, over the long term.

Limits: Describes how success is defined, not how often it is achieved.

Long-term survival Longitudinal clinical study · 245 patients, 980 implants · up to 10 years

A longitudinal study of the survival of All-on-4 implants in the mandible with up to 10 years of follow-up.

Malo P, de Araújo Nobre M, Lopes A, Moss SM, Molina GJ. J Am Dent Assoc 2011. PMID 21357865

What it found: 21 implants failed in 13 patients. Cumulative implant-related success was 98.1% at five years and 94.8% with up to 10 years of follow-up; patient-related success was 94.8% and 93.8%. Bridge (prosthesis) survival was 99.2%.

What it means for you: In the lower jaw, four implants carrying fixed teeth straight after surgery held up well over a decade in this group.

Limits: From the clinic that developed the concept, with Nobel Biocare implants; lower jaw only. All-on-4 is a Nobel Biocare trademark; we are not affiliated.

Long-term survival Retrospective case series · 471 patients, 1,884 implants · 10 to 18 years

The All-on-4 treatment concept for the rehabilitation of the completely edentulous mandible: A longitudinal study with 10 to 18 years of follow-up.

Maló P, de Araújo Nobre M, Lopes A, Ferro A, Botto J. Clin Implant Dent Relat Res 2019. PMID 30924309

What it found: Bridge survival was 98.8%; implant survival 93% and implant success 91.7% up to 18 years. Average bone loss was 1.72 mm at 10 years and 2.32 mm at 15 years. Biological complications affected 11.8% of implants and mechanical complications 36.7%. Smoking was linked with more bone loss.

What it means for you: The bridge itself rarely had to be abandoned, but over many years more than a third of cases needed some mechanical repair. Plan for maintenance.

Limits: 149 patients (31.6%) were lost to follow-up and 27 had died, which can make long-term figures look better than they are. Single centre.

Long-term survival Systematic review and meta-analysis · 17 prospective studies, 501 patients, 2,827 implants · at least 5 years

Implant and prosthodontic survival rates with implant fixed complete dental prostheses in the edentulous mandible after at least 5 years: a systematic review.

Papaspyridakos P, Mokti M, Chen CJ, Benic GI, Gallucci GO, Chronopoulos V. Clin Implant Dent Relat Res 2014. PMID 23311617

What it found: Rough-surface implant survival was 98.42% at 5 years and 96.86% at 10 years. One-piece fixed full-arch bridges survived 98.61% at 5 years and 97.25% at 10 years. The number of implants and loading protocol made no significant difference to these rates.

What it means for you: For a fixed lower full arch, more than 96% of implants and bridges were still in use after 10 years in prospective studies.

Limits: Lower jaw only; most implants were placed between the two mental foramina; prospective studies tend to include healthier, carefully selected patients.

Long-term survival Systematic review · 13 studies, 4,804 implants, 1,201 bridges · mean figures at 36 months

The all-on-four treatment concept: a systematic review.

Patzelt SB, Bahat O, Reynolds MA, Strub JR. Clin Implant Dent Relat Res 2014. PMID 23560986

What it found: 74 of 4,804 implants failed, 74% of the failures within the first 12 months. Mean cumulative survival at 36 months was 99.0% for implants and 99.9% for bridges; average bone loss 1.3 mm. The main prosthetic problem was fracture of all-acrylic bridges. No significant difference between upper and lower jaws, or between straight and tilted implants.

What it means for you: Most failures happen early, during healing. Tilting the back implants did not show worse results in this review.

Limits: The authors call the results promising but short term, with limited study quality and few data beyond five years.

Long-term survival Systematic review, sensitivity meta-analysis · 18 prospective studies · 10 years

Long-term (10-year) dental implant survival: A systematic review and sensitivity meta-analysis.

Howe MS, Keys W, Richards D. J Dent 2019. PMID 30904559

What it found: The standard estimate of 10-year implant survival was 96.4%. When the authors allowed for patients lost to follow-up, the estimate fell to 93.2%, with a prediction interval of 76.6% to 100%. Age 65 or over was a significant predictor (91.5%).

What it means for you: Headline survival numbers can be optimistic because people who drop out of studies are not counted. Older patients may carry roughly twice the risk of implant loss.

Limits: Covers implants in general, not only full-arch cases.

Long-term survival Systematic review · 23 studies, 7,711 implants · mean 13.4 years

Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review.

Moraschini V, Poubel LA, Ferreira VF, Barboza Edos S. Int J Oral Maxillofac Surg 2015. PMID 25467739

What it found: Across studies with at least 10 years of follow-up, mean implant survival was 94.6% and mean marginal bone loss 1.3 mm.

What it means for you: A useful long-term benchmark for implants in general.

Limits: Mixed indications (not only full arch) and different outcome definitions across studies, as the authors note.

Long-term survival Consecutive cohort · 76 patients, 450 implants · 15 years

Implant treatment in the edentulous maxillae: a 15-year follow-up study on 76 consecutive patients provided with fixed prostheses.

Jemt T, Johansson J. Clin Implant Dent Relat Res 2006. PMID 16774591

What it found: 15-year cumulative survival was 90.9% for implants and 90.6% for fixed bridges in the upper jaw. Most implant losses happened early. Resin veneer fractures and, later, wear were the main problems. Only 1.3% of implants had more than 3.0 mm of bone loss after 15 years.

What it means for you: Upper-jaw full arches can last 15 years, but the tooth surfaces wear and chip and need upkeep.

Limits: 44 of 76 patients were lost to follow-up; older machined (turned) implants.

Long-term survival Prospective study · 47 patients, 273 implants · 20 to 23 years

Implant treatment in the edentulous mandible: a prospective study on Brånemark system implants over more than 20 years.

Ekelund JA, Lindquist LW, Carlsson GE, Jemt T. Int J Prosthodont 2003. PMID 14714838

What it found: Three implants were lost over the whole period; 20-year implant survival was 98.9%. All patients still had working lower bridges, though two had them remade. Bone loss between 15 and 20 years averaged 0.2 mm.

What it means for you: Some of the longest data available: lower full-arch bridges on implants can work for more than two decades.

Limits: Small group; 30 patients attended at 20 years; older implant design.

Long-term survival Meta-research (study of studies) · 41 trials from 5 systematic reviews · trials published 1993–2008

Relationship between sponsorship and failure rate of dental implants: a systematic approach.

Popelut A, Valet F, Fromentin O, Thomas A, Bouchard P. PLoS One 2010. PMID 20422000

What it found: The mean annual implant failure rate across the trials was 1.09%. 63% of trials did not report who funded them. After adjusting for study age, industry-associated trials (OR 0.21) and trials with unknown funding (OR 0.33) reported lower annual failure rates than non-industry trials.

What it means for you: Who paid for a study is worth checking. Industry-linked trials reported fewer failures, which does not prove bias in any single trial but is a reason to read funding statements.

Limits: Older trials; association, not proof of cause; only 41 analysable trials.

Long-term survival Population-based cohort (random national sample) · 2,765 patients, 11,311 implants; 596 examined at 9 years · 9 years

Effectiveness of implant therapy analyzed in a Swedish population: early and late implant loss.

Derks J, Håkansson J, Wennström JL, Tomasi C, Larsson M, Berglundh T. J Dent Res 2015. PMID 25503901

What it found: Early implant loss affected 4.4% of patients (1.4% of implants). At 9 years, 4.2% of examined patients had late implant loss (2.0% of implants). Overall 7.6% of patients had lost at least one implant. Smoking and a history of periodontitis raised the odds of early loss; implants shorter than 10 mm and certain brands also did.

What it means for you: In everyday practice across a whole country, losing an implant is not rare, and results reported per patient look less rosy than results per implant.

Limits: Only 596 of 2,765 patients attended the 9-year examination; Swedish care system; implants placed in 2003.

Long-term survival Consensus report based on systematic reviews · ITI Consensus Conference group · 1 to 5 years in included studies

Group 1 ITI Consensus Report: The influence of implant length and design and medications on clinical and patient-reported outcomes.

Jung RE, et al. Clin Oral Implants Res 2018. PMID 30328189

What it found: Short implants (6 mm or less) survived at 86.7% to 100% against 95% to 100% for standard implants, with more variability. Narrow implants of 2.5 mm and wider had mean survival of 97.3% to 97.7%; mini-implants under 2.5 mm 94.7%.

What it means for you: Short and narrow implants work, but the shorter and thinner they get, the less predictable the results.

Limits: Follow-up mostly up to 5 years.

Long-term survival Systematic review · 42 articles

Clinical performance of intentionally tilted implants versus axially positioned implants: A systematic review.

Lin WS, Eckert SE. Clin Oral Implants Res 2018. PMID 30328193

What it found: Descriptive data showed no differences in implant survival, marginal bone loss, prosthesis survival or patient-reported outcomes between tilted and upright implants.

What it means for you: Tilting the back implants to avoid the nerve or sinus did not appear to cost survival.

Limits: Studies were too different to pool; only one directly compared the two.

Complications and maintenance

Complications and maintenance Systematic review and meta-analysis · 32 studies · at least 5 years

A systematic review of the survival and complication rates of implant-supported fixed dental prostheses (FDPs) after a mean observation period of at least 5 years.

Pjetursson BE, Thoma D, Jung R, Zwahlen M, Zembic A. Clin Oral Implants Res 2012. PMID 23062125

What it found: Implants supporting bridges survived 95.6% at 5 years and 93.1% at 10 years (97.2% at 5 years for rough-surface implants). Metal-ceramic bridges survived 96.4% at 5 and 93.9% at 10 years. Only 66.4% of patients were free of any complication after 5 years. Commonest problems: veneer fractures (13.5%), peri-implantitis and soft-tissue problems (8.5%), loss of the access-hole filling (5.4%), abutment or screw loosening (5.3%).

What it means for you: About one in three patients needed some repair or treatment within five years. That is normal maintenance, not necessarily failure.

Limits: Includes partial bridges as well as full arches.

Complications and maintenance Systematic review and meta-analysis · 11 studies (9 metal-ceramic, 2 all-ceramic) · at least 5 years mean

Prosthodontic Complications of Metal-Ceramic and All-Ceramic, Complete-Arch Fixed Implant Prostheses with Minimum 5 Years Mean Follow-Up Period. A Systematic Review and Meta-Analysis.

Wong CKK, Narvekar U, Petridis H. J Prosthodont 2019. PMID 29665177

What it found: Metal-ceramic full-arch bridges mostly survived (range 92.4% to 100%), but success ranged from 47% to 96.7%. Cumulative veneer-fracture rates were 22.1% at 5 years and 39.3% at 10 years. In the two all-ceramic studies, success was 90.9% with mostly monolithic zirconia and 60.4% with layered zirconia.

What it means for you: Chipping of the porcelain surface is the main long-term issue with full-arch bridges; monolithic (single-block) zirconia looked better in the small amount of data available.

Limits: Only two all-ceramic studies; confidence intervals were wide.

Complications and maintenance Retrospective cohort · 52 patients, 71 full-arch bridges, 457 implants · mean 5.2 years (1 to 12)

Technical Complications and Prosthesis Survival Rates with Implant-Supported Fixed Complete Dental Prostheses: A Retrospective Study with 1- to 12-Year Follow-Up.

Papaspyridakos P, Bordin TB, Kim YJ, El-Rafie K, Pagni SE, Natto ZS, Teixeira ER, Chochlidakis K, Weber HP. J Prosthodont 2020. PMID 31650669

What it found: Bridge survival was 91.6%. Wear of the tooth material was the commonest minor problem (estimated 5-year rate 49.0%); fracture of the tooth material the commonest major one (5-year rate 9.5%). Bridges free of major technical complications: 85.5% at 5 years, 30.1% at 10 years. Bruxism and not wearing a night guard raised the risk of chipping.

What it means for you: By year 10 most full-arch bridges in this cohort had needed some technical repair. If you grind your teeth, a night guard matters.

Limits: Single university cohort, retrospective, small numbers at 10 years (wide confidence intervals).

Complications and maintenance Systematic review and meta-analysis of 21 in vitro studies · 50,000 to 3,000,000 load cycles · laboratory

Impact of implant abutment connection designs and cyclic loading on screw stability in dental implants: A systematic review and meta-analysis.

Sammour SR, et al. J Prosthet Dent 2026. PMID 41102040

What it found: Pooled torque loss after cyclic loading was 23.9% for external hexagon, 19.2% for internal hexagon, 16.6% for Morse taper and 16.0% for conical connections. Angled abutments increased torque loss.

What it means for you: Every screw loses some tightening force once you chew on it. Conical designs hold it a little better.

Limits: Laboratory loading, high heterogeneity.

Complications and maintenance Narrative review · more than 30 included papers

Occlusion on oral implants: current clinical guidelines.

Koyano K, Esaki D. J Oral Rehabil 2015. PMID 25284468

What it found: Reviewed cantilevers, crown-to-implant ratio, premature contacts, occlusal scheme, connection type and splinting, and found insufficient evidence to set firm clinical guidelines for implant occlusion.

What it means for you: Bite design on implants rests largely on clinical experience and mechanics, not trials.

Limits: Narrative, not systematic; literature to 2013.

Complications and maintenance Systematic review · 1,315 records screened

The bases for using a particular occlusal design in tooth and implant-borne reconstructions and complete dentures.

Klineberg I, Kingston D, Murray G. Clin Oral Implants Res 2007. PMID 17594379

What it found: There was little scientific evidence specifying occlusal and superstructure design for fixed prostheses on teeth or implants, and no evidence that a particular design is superior.

What it means for you: Different bite schemes are reasonable choices; the jaw muscles adapt to change.

Limits: Older review; few controlled trials existed.

Complications and maintenance Systematic review and meta-analysis · 26 articles · 10 days and 1 year

Systematic Review and Meta-Analysis on Incidence of Altered Sensation of Mandibular Implant Surgery.

Lin CS, Wu SY, Huang HY, Lai YL. PLoS One 2016. PMID 27100832

What it found: Altered sensation after lower-jaw implant surgery was reported in 13% of patients at 10 days and 3% at one year. Of those who had altered sensation at first, 91% had normal sensation by one year.

What it means for you: Short-lived numbness or tingling is fairly common; lasting change is uncommon but real, and you should be told about it before consenting.

Limits: Studies defined and measured altered sensation in different ways.

Complications and maintenance Umbrella review · 7 systematic reviews · 5 to 15 years

Prosthetic complications of implant-supported complete arch prostheses: An umbrella review of systematic reviews.

Tomar S, et al. J Prosthet Dent 2026. PMID 41927400

What it found: Prosthesis survival ranged from 89.5% to 96.8% and implant survival from 95.2% to 99.2%. Screw loosening was reported in 5% to 15%, veneer chipping in 15% to 35% of veneered zirconia, framework fracture in under 5%.

What it means for you: Full-arch bridges last well, but small mechanical repairs over the years are normal and should be budgeted for.

Limits: Pools reviews of varying quality.

Complications and maintenance Systematic review · 6 studies

Clinical implications of misfit in multiunit implant-supported fixed dental prostheses: A systematic review.

He Z, et al. J Prosthodont 2026. PMID 42693826

What it found: Most studies found no consistent link between framework misfit and clinical outcomes; one found more screw complications with greater misfit.

What it means for you: Fit is pursued for mechanical reasons, especially screw stability, even though the clinical evidence is thin.

Limits: Very few long-term studies; weak control of confounding.

Gum and bone around implants

Gum and bone around implants Random population sample · 588 patients · 9 years after treatment

Effectiveness of Implant Therapy Analyzed in a Swedish Population: Prevalence of Peri-implantitis.

Derks J, Schaller D, Håkansson J, Wennström JL, Tomasi C, Berglundh T. J Dent Res 2016. PMID 26701919

What it found: 45% of patients had peri-implantitis (bleeding or pus plus bone loss over 0.5 mm) and 14.5% had moderate or severe peri-implantitis (bone loss over 2 mm). Higher odds were seen in people with periodontitis, people with four or more implants, certain implant brands and treatment by general practitioners.

What it means for you: Gum and bone inflammation around implants is common in everyday practice. People with many implants, such as full-arch patients, should expect regular checks.

Limits: Swedish patients treated in the early 2000s; the 0.5 mm threshold is low, which is why the 14.5% figure is often quoted for clinically important disease.

Gum and bone around implants Systematic review and meta-analysis · 11 studies

Peri-implant health and disease. A systematic review of current epidemiology.

Derks J, Tomasi C. J Clin Periodontol 2015. PMID 25495683

What it found: Weighted mean prevalence was 43% for peri-implant mucositis and 22% for peri-implantitis, with very wide ranges (19% to 65% and 1% to 47%) because studies used different case definitions. Peri-implantitis became more common with longer time in function.

What it means for you: Mucositis (gum inflammation without bone loss) is common and reversible; peri-implantitis is less common but harder to treat.

Limits: Case definitions varied, which is why the 2017 World Workshop set common ones.

Gum and bone around implants International consensus report

Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions.

Berglundh T, Armitage G, Araujo MG, et al. J Clin Periodontol 2018. PMID 29926491

What it found: Defined peri-implant health (no redness, bleeding on probing, swelling or pus), peri-implant mucositis (mainly bleeding on gentle probing; plaque is the cause) and peri-implantitis (plaque-associated inflammation with progressive loss of supporting bone). Evidence on keratinised gum is equivocal, though it may help comfort and cleaning. Baseline X-rays and probing after the bridge is fitted are recommended.

What it means for you: Ask for baseline X-rays and measurements when your final teeth are fitted, so later changes can be judged.

Limits: Consensus definitions, not outcome data.

Gum and bone around implants Review for the 2017 World Workshop

Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations.

Renvert S, Persson GR, Pirih FQ, Camargo PM. J Clin Periodontol 2018. PMID 29926496

What it found: Peri-implantitis is diagnosed by signs of inflammation, bone loss on X-ray after initial healing and increasing probing depth. Without earlier X-rays, bone level of 3 mm or more with bleeding and probing depths of 6 mm or more indicates peri-implantitis.

What it means for you: Your implant passport and copies of your X-rays let a dentist anywhere compare later images with the starting point.

Limits: Diagnostic definitions, not prevalence figures.

Gum and bone around implants Narrative review for the 2017 World Workshop

Peri-implantitis.

Schwarz F, Derks J, Monje A, Wang HL. J Clin Periodontol 2018. PMID 29926484

What it found: Strong evidence links peri-implantitis with a history of chronic periodontitis, poor plaque control and no regular maintenance after treatment. Evidence on smoking and diabetes as risk factors for peri-implantitis was inconclusive. Disease can start early and progress in a non-linear, accelerating way.

What it means for you: The three things most within your control are cleaning, regular maintenance visits and treating gum disease.

Limits: Narrative review.

Gum and bone around implants Systematic review and meta-analysis · 11 studies · at least 6 months

The significance of keratinized mucosa on implant health: a systematic review.

Lin GH, Chan HL, Wang HL. J Periodontol 2013. PMID 23451989

What it found: A lack of adequate keratinised (firm, attached) gum around implants was associated with more plaque, more tissue inflammation, more gum recession and more attachment loss. Bleeding on probing, probing depth and X-ray bone loss did not differ significantly.

What it means for you: Firm gum around implants seems to make them easier to keep clean and comfortable.

Limits: Mostly cross-sectional studies with moderate to high heterogeneity.

Gum and bone around implants Population-based cohort, statistical growth model · 62 patients, 105 affected implants · 9 years

Peri-implantitis - onset and pattern of progression.

Derks J, Schaller D, Håkansson J, Wennström JL, Tomasi C, Berglundh T. J Clin Periodontol 2016. PMID 26900869

What it found: Bone loss at affected implants followed a non-linear, accelerating pattern. 52% and 66% of affected implants already showed bone loss over 0.5 mm at years 2 and 3; for most cases, onset was within 3 years of function.

What it means for you: Peri-implantitis tends to start early and speed up, so the first few years of check-ups and X-rays are the most useful time to catch it.

Limits: Based on the subgroup with moderate or severe disease; modelled rather than yearly measured bone levels.

Gum and bone around implants Systematic review and meta-analysis of controlled trials · 10 studies, 1,239 implants · varied

Platform switching for marginal bone preservation around dental implants: a systematic review and meta-analysis.

Atieh MA, Ibrahim HM, Atieh AH. J Periodontol 2010. PMID 20575657

What it found: Bone loss around platform-switched implants was significantly lower than around platform-matched implants (mean difference 0.37 mm). Implant failure did not differ between the two designs.

What it means for you: A narrower abutment on a wider implant platform seems to save a few tenths of a millimetre of bone. It did not change whether implants survived.

Limits: Small studies with different designs; bone differences are small in absolute terms.

Gum and bone around implants Narrative review

Initial and long-term crestal bone responses to modern dental implants.

Albrektsson T, Chrcanovic B, Östman PO, Sennerby L. Periodontol 2000 2017. PMID 28000272

What it found: Marginal bone loss in the first years seldom represents disease; it is usually an adaptive response to surgery and loading, often followed by long-lasting stability. The authors estimate only 1% to 2% of implants placed by trained clinicians show true peri-implantitis over 10 years or more.

What it means for you: Some early bone change around an implant is expected. Steady loss after the first year needs checking.

Limits: Expert opinion; other groups report higher peri-implantitis rates with different definitions.

Gum and bone around implants Umbrella review and meta-meta-analysis · 10 systematic reviews (2012 to 2023)

Significance of peri-implant keratinised mucosa on implant health: An umbrella systematic review with evidence mapping and quantitative meta-meta-analysis.

Sabri H, Tavelli L, Sheikh AT, et al. Int J Oral Implantol (Berl) 2025. PMID 40047360

What it found: A band of keratinised gum narrower than 2 mm was associated with more mucosal recession (equivalent odds ratio 4.05), higher gingival index scores (3.131), higher plaque index scores (5.34) and greater marginal bone loss (1.852). No significant association was found for bleeding on probing or pocket depth.

What it means for you: Firm gum around implants seems to make them easier to keep clean and calm, but the authors found insufficient evidence on implant survival.

Limits: Pools earlier reviews, so it inherits their mixed study designs and heterogeneity.

Gum and bone around implants Systematic review and meta-analysis · 30 articles

The relationship between adequate keratinized mucosa and peri-implant disease: a systematic review and meta-analysis.

Zhang Z, Zhang Z, Wang P, et al. BMC Oral Health 2025. PMID 40050830

What it found: Implants with at least 2 mm of keratinised mucosa had lower plaque index (mean difference -0.30), gingival index (-0.26), bleeding index (-0.20) and bone loss (-0.27).

What it means for you: Supports planning for, or preserving, a band of firm gum where practical.

Limits: Significant heterogeneity between the included studies; differences are small in absolute terms.

Gum and bone around implants Systematic review and meta-analysis · 16 studies

Periodontitis, implant loss and peri-implantitis. A meta-analysis.

Sgolastra F, Petrucci A, Severino M, et al. Clin Oral Implants Res 2015. PMID 24382358

What it found: People with a history of periodontitis (gum disease) had a higher risk of implant loss (risk ratio 1.69) and of peri-implantitis (risk ratio 2.17) than people with healthy gums.

What it means for you: If you lost teeth to gum disease, regular professional cleaning around implants matters even more.

Limits: Only 16 studies met the inclusion criteria.

Gum and bone around implants Systematic review and meta-analysis · 13 trials (10 in meta-analysis)

Impact of Maintenance Therapy for the Prevention of Peri-implant Diseases: A Systematic Review and Meta-analysis.

Monje A, Aranda L, Diaz KT, et al. J Dent Res 2016. PMID 26701350

What it found: Regular peri-implant maintenance was linked with fewer biological complications, and a history of gum disease raised the risk. The authors suggested a minimum recall interval of 5 to 6 months, tailored to each person's risk.

What it means for you: Plan who will clean and check your implants near home before you travel.

Limits: Complications still occurred under maintenance; risk profiles differ.

Bone loss and grafting

Bone loss and grafting Cross-sectional study of dried skulls · 300 skulls

A classification of the edentulous jaws.

Cawood JI, Howell RA. Int J Oral Maxillofac Surg 1988. PMID 3139793

What it found: The basal bone of the jaws stays fairly stable, but the tooth-bearing (alveolar) ridge changes shape in a predictable pattern after tooth loss, in height and width. The paper sets out classes from a jaw with teeth to a flat, low ridge.

What it means for you: Dentists still use these classes to describe how much ridge is left and which techniques fit.

Limits: Based on dried skulls; describes shape, not the bone quality a CBCT scan shows.

Bone loss and grafting Systematic review · 20 studies · up to 12 months

A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans.

Tan WL, Wong TL, Wong MC, Lang NP. Clin Oral Implants Res 2012. PMID 22211303

What it found: Six months after extraction, re-entry studies showed horizontal bone loss of 29% to 63% and vertical loss of 11% to 22%. Width fell by 3.79 mm on average versus 1.24 mm of height on the cheek side. Most of the change happened in the first 3 to 6 months.

What it means for you: The ridge narrows quickly after teeth are taken out, which is one reason implants are often placed on the day of extraction in full-arch cases.

Limits: Mostly single-tooth extraction sites, not whole-arch clearances.

Bone loss and grafting Prospective study · 46 patients · 12 months

Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study.

Schropp L, Wenzel A, Kostopoulos L, Karring T. Int J Periodontics Restorative Dent 2003. PMID 12956475

What it found: After removal of a premolar or molar, major changes in the extraction site happened during the first year, measured on study models and X-rays.

What it means for you: A classic paper on how fast a socket and ridge reshape after an extraction.

Limits: Single back teeth only; the abstract does not give the millimetre figures, so we do not quote them.

Bone loss and grafting Review

Clinical relevance of dimensional bone and soft tissue alterations post-extraction in esthetic sites.

Chappuis V, Araújo MG, Buser D. Periodontol 2000 2017. PMID 28000281

What it found: Front-tooth sites with a thin facial bone wall (1 mm or less) lost about 7.5 mm of bone height after extraction, against 1.1 mm for thick walls. Socket preservation can reduce, but not stop, this resorption.

What it means for you: The thickness of the bone in front of the roots, visible on CBCT, predicts how much will be lost.

Limits: Aesthetic (front) sites; narrative review.

Bone loss and grafting Systematic review of 8 RCTs · 8 randomised trials · 8 to 18 months

EAO Supplement Working Group 4 - EAO CC 2015 Short implants versus sinus lifting with longer implants to restore the posterior maxilla: a systematic review.

Thoma DS, Zeltner M, Hüsler J, Hämmerle CH, Jung RE. Clin Oral Implants Res 2015. PMID 25997901

What it found: At 16 to 18 months, survival was 99.5% for longer implants in a lifted sinus and 99.0% for short implants (8 mm or less). Complications, mostly membrane perforations during surgery, were almost three times higher with sinus lifting. Patient-reported outcomes, surgery time and cost favoured short implants.

What it means for you: Where there is a little bone under the sinus, a short implant can be a gentler alternative to a sinus lift.

Limits: Short follow-up; all studies done by specialist surgeons.

Bone loss and grafting Clinical cohort · 47 patients · mean 40 months (lower) and 53 months (upper)

Tilting of posterior mandibular and maxillary implants for improved prosthesis support.

Krekmanov L, Kahn M, Rangert B, Lindström H. Int J Oral Maxillofac Implants 2000. PMID 10874806

What it found: Tilting back implants about 25–35 degrees gained a mean 6.5 mm of prosthesis support in the lower jaw and 9.3 mm in the upper jaw without nerve repositioning or sinus grafting. No lower-jaw implants failed; 5-year cumulative success in the upper jaw was 98% for tilted and 93% for straight implants.

What it means for you: Angling the back implants is an established way to support more teeth when bone is short at the back of the jaw.

Limits: Small group; medium-term follow-up.

Bone loss and grafting Reliability study · 26 expert clinicians, 110 CBCT cross-sections · repeat rating after one month

Inter and intra-operator reliability of Lekholm and Zarb classification and proposal of a novel radiomic data-driven clustering for qualitative assessment of edentulous alveolar ridges.

Troiano G, Rapani A, Fanelli F, et al. Clin Oral Implants Res 2024. PMID 38629945

What it found: Agreement between clinicians using the Lekholm and Zarb bone classes was minimal (Fleiss kappa 0.273 and 0.243), and agreement of each clinician with themselves a month later was weak (kappa 0.515).

What it means for you: Bone 'types' read from a scan are a useful rough guide, not a precise measurement. Two dentists may label the same bone differently.

Limits: Images only, no surgical feel of the bone.

Bone loss and grafting Retrospective analysis · 1,000 implants · mean 3.6 years

Medium-term clinical outcomes of the all-on-4 system in different bone types: a retrospective analysis.

Topdagi B, et al. BMC Oral Health 2026. PMID 42472808

What it found: Overall implant survival was 94.8%, lower in Type 4 bone (89.1%) than Type 1 bone (98.3%). Prosthetic complications were more frequent with metal-acrylic (26.9%) than zirconia (8.9%) prostheses.

What it means for you: Soft, low-density bone carried a higher failure risk in this four-implant series.

Limits: Retrospective, single setting, medium-term.

Bone loss and grafting Systematic review of 4 RCTs · 135 patients · 5 years after loading

Short implants versus longer implants in vertically augmented atrophic mandibles: A systematic review of randomised controlled trials with a 5-year post-loading follow-up.

Esposito M, et al. Int J Oral Implantol (Berl) 2019. PMID 31535097

What it found: Implant and prosthesis failures did not differ, but patients with longer implants in grafted bone had more complications (risk ratio 4.72) and 0.60 mm more bone loss. 14% of grafts failed to give the planned bone height.

What it means for you: In the back of the lower jaw, a short implant avoided the problems of a vertical graft without doing worse over five years.

Limits: Small trials, 21% drop-out by five years.

Bone loss and grafting Systematic review and meta-analysis, 8 RCTs · up to 8 years

Vertical bone augmentation and regular implants versus short implants in the vertically deficient posterior mandible: a systematic review and meta-analysis of randomized studies.

Terheyden H, Meijer GJ, Raghoebar GM. Int J Oral Maxillofac Surg 2021. PMID 33589294

What it found: Implant loss was similar at 3, 5 and 8 years. Complications favoured short implants (risk ratio 0.34), and short implants lost less marginal bone at 3, 5 and 8 years.

What it means for you: Short implants and grafting plus standard implants gave comparable results in the first five years in the lower back jaw.

Limits: Few trials; residual bone contact on short implants was only about 3 to 4.4 mm.

Bone loss and grafting Systematic review of randomised trials · 35 articles

Use of platelet-rich fibrin in regenerative dentistry: a systematic review.

Miron RJ, Zucchelli G, Pikos MA, et al. Clin Oral Investig 2017. PMID 28551729

What it found: Most trials showed favourable results for periodontal defects and gum recession. Very little to no data directly investigated PRF for new bone formation in bone augmentation, peri-implantitis treatment or sinus lifts.

What it means for you: PRF has better support for soft tissue healing than for growing bone.

Limits: Searches ran to May 2016; several authors are prominent PRF researchers.

Bone loss and grafting Systematic review of RCTs and controlled trials · 7 studies

Implants with or without Leukocyte- and Platelet-Rich Fibrin (L-PRF): A Systematic Review on Dental Implant Stability.

Damsaz M, Rahmani F, Arzani S, et al. J Maxillofac Oral Surg 2025. PMID 40756903

What it found: The authors concluded that L-PRF may enhance implant stability (ISQ readings) after surgery.

What it means for you: A possible small benefit to early stability; not evidence of better long-term survival.

Limits: Only seven studies; stability readings are a surrogate measure.

Bone loss and grafting Systematic review · 7 publications

The efficacy of platelet-rich fibrin in immediate dental implant placement: a systematic literature review.

Pliatkute I, Pliavga V, Jakonyte A, Juodzbalys G. Minerva Dent Oral Sci 2026. PMID 41378897

What it found: In single immediate implants, stability results slightly favoured PRF over a blood clot or collagen with bone substitute, but were inferior to bone substitute alone; no significant differences were seen between materials across studies.

What it means for you: PRF is one option for filling the gap around an immediate implant, not a clearly superior one.

Limits: Single-tooth immediate implants only; small, varied studies.

Bone loss and grafting Systematic review (no meta-analysis) · 200 comparative clinical studies

Analgesic effects of platelet-rich fibrin (PRF): A systematic review.

Estrin NE, Tran TB, Ahmad P, et al. Periodontol 2000 2025. PMID 41084140

What it found: Almost all included studies reported less pain in the PRF group than in controls. Differences in PRF preparation and outcome measures prevented a meta-analysis.

What it means for you: PRF may reduce pain after some procedures, but the studies are too varied to give a reliable size of effect.

Limits: Heterogeneous studies; some authors are affiliated with a PRF education company.

Bone loss and grafting Systematic review and meta-analysis · 48 studies, 12,020 implants · at least 1 year after loading

A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation.

Pjetursson BE, Tan WC, Zwahlen M, Lang NP. J Clin Periodontol 2008. PMID 18724852

What it found: Implants placed with lateral-window sinus floor elevation had an estimated 3-year survival of 90.1% across all studies. The best results, 98.3% at 3 years, came from rough-surface implants with a membrane covering the lateral window.

What it means for you: A sinus lift is an established way to gain bone in the back of the upper jaw. Technique and implant surface made a real difference to the numbers.

Limits: Older studies, mixed techniques and implant types; per-patient figures were less favourable than per-implant figures.

Bone loss and grafting Systematic review and meta-analysis · 19 studies · at least 1 year after loading

A systematic review of the success of sinus floor elevation and survival of implants inserted in combination with sinus floor elevation. Part II: transalveolar technique.

Tan WC, Lang NP, Zwahlen M, Pjetursson BE. J Clin Periodontol 2008. PMID 18724853

What it found: Implants placed with the transalveolar (crestal) sinus lift had an estimated 3-year survival of 92.8%, comparable to implants in sites that needed no augmentation.

What it means for you: When only a few millimetres of extra height are needed, the smaller crestal approach performs well.

Limits: Cohort studies only; results depend on how much bone was present to begin with.

Bone loss and grafting Systematic review and network meta-analysis · 85 studies, 5,551 procedures

The Impact of Sinus Floor Elevation Techniques on Sinus Membrane Perforation: A Systematic Review and Network Meta-analysis.

Lee CT, Choksi K, Shih MC, Rosen PS, Ninneman S, Hsu YT. Int J Oral Maxillofac Implants 2023. PMID 37669518

What it found: Tearing of the sinus lining was linked to lower implant survival (odds ratio 0.45 per 10% increase in perforation rate). Some instruments within each approach carried less risk than others.

What it means for you: How gently the sinus lining is lifted matters, whichever approach is used.

Limits: Indirect comparisons; the authors call for randomised trials.

Bone loss and grafting Systematic review and meta-analysis · 94 publications

Bone Quality and Quantity and Dental Implant Failure: A Systematic Review and Meta-analysis.

Chrcanovic BR, Albrektsson T, Wennerberg A. Int J Prosthodont 2017. PMID 28319206

What it found: Implants placed in the softest bone (Lekholm and Zarb type 4) failed more often than implants in all other bone types. Lack of bone volume was also associated with more failures.

What it means for you: Soft bone is a recognised risk factor, which is one reason the upper back jaw is planned differently.

Limits: Bone quality is graded subjectively in most studies.

Zygomatic implants and severe bone loss

Zygomatic implants and severe bone loss Systematic review · 68 studies, 2,161 patients, 4,556 zygomatic implants · up to 12 years

Survival and Complications of Zygomatic Implants: An Updated Systematic Review.

Chrcanovic BR, Albrektsson T, Wennerberg A. J Oral Maxillofac Surg 2016. PMID 27422530

What it found: 12-year cumulative survival was 95.21%, with most failures in the first 6 months. Immediate loading had lower failure than delayed loading. Complication rates: sinusitis 2.4%, soft-tissue infection 2.0%, numbness 1.0%, oro-antral fistula 0.4%.

What it means for you: Zygomatic implants survive well; sinus problems are the main thing to watch, sometimes years later.

Limits: The authors warn complication rates may be underestimated because many studies did not report them.

Zygomatic implants and severe bone loss Consensus report based on systematic reviews · 21 consensus statements · mean 6.3 years

ITI consensus report on zygomatic implants: indications, evaluation of surgical techniques and long-term treatment outcomes.

Al-Nawas B, Aghaloo T, Aparicio C, et al. Int J Implant Dent 2023. PMID 37698775

What it found: Zygomatic implants are mainly indicated for upper-jaw bone atrophy. Long-term mean survival was 96.2% over a mean 6.3 years. Immediate loading showed higher survival than delayed loading. Sinusitis had a total prevalence of 14.2% over a mean 65.4 months and was the commonest complication.

What it means for you: The best current summary of when cheekbone implants make sense, and an honest figure for sinus trouble.

Limits: Note how the sinusitis figure differs from the 2016 review: definitions and reporting matter.

Zygomatic implants and severe bone loss Consecutive case series · 22 patients, 41 zygomatic + 131 regular implants · at least 10 years

The long-term use of zygomatic implants: a 10-year clinical and radiographic report.

Aparicio C, Manresa C, Francisco K, et al. Clin Implant Dent Relat Res 2014. PMID 23078128

What it found: 10-year survival was 95.12% for zygomatic and 97.71% for regular implants; all patients kept working bridges. Screws loosened or broke in 11 patients and tooth material fractured in seven. Six patients had sinusitis at some point; 84% reported satisfaction above 80%.

What it means for you: Ten-year data exist, and they show both reliable anchorage and a steady need for maintenance.

Limits: Small, single-centre series.

Zygomatic implants and severe bone loss Cochrane systematic review · 2 RCTs · 3 years

Interventions for replacing missing teeth: zygomatic implants for the rehabilitation of the severely atrophic edentulous maxilla.

Visconti RF, Greco K, Cotticelli C, Ambrosi A, Esposito MA. Cochrane Database Syst Rev 2026. PMID 42489150

What it found: Compared with conventional implants in grafted bone, zygomatic implants probably reduce implant failures (OR 0.23) but probably increase complications (OR 4.53). Time to rehabilitation was about 1.3 days with zygomatic implants versus about 444 days with bone grafting.

What it means for you: The trade-off is clear: teeth much sooner and fewer failed implants, at the price of more complications.

Limits: Only one trial for this comparison; low to moderate certainty evidence.

Zygomatic implants and severe bone loss Systematic review and meta-analysis · 6 studies, 3,844 implants (904 pterygoid)

Effectiveness of pterygoid dental implants in the complete arch rehabilitation of the edentulous maxilla: a systematic review and meta-analysis.

Diniz DA, Sales PHH, Silva PGB, Giovannacci I, Vescovi P, Leão JC. Int J Oral Maxillofac Surg 2026. PMID 42728116

What it found: Pterygoid implants survived at 95.25% against 97.88% for conventional implants; the risk of losing a pterygoid implant was higher (risk ratio 1.54).

What it means for you: Anchoring at the very back of the upper jaw is a workable option, with slightly lower survival than standard implants.

Limits: Only six studies, three at high risk of bias.

Zygomatic implants and severe bone loss Systematic review and meta-analysis · 18 studies, 1,349 zygomatic implants, 623 patients · mean 75.4 months

Long-term treatment outcomes with zygomatic implants: a systematic review and meta-analysis.

Brennand Roper M, Vissink A, Dudding T, et al. Int J Implant Dent 2023. PMID 37405545

What it found: Zygomatic implant survival was 96.2% at 6 years (98.1% with immediate loading, 95% with delayed loading). Prosthesis survival was 94%. Sinusitis prevalence was 14.2% at 5 years.

What it means for you: Survival is comparable to conventional implants, but sinus problems are more common than older reviews suggested.

Limits: Mostly observational studies with different surgical techniques.

Zygomatic implants and severe bone loss Systematic review · 38 studies, 2,245 patients, 3,446 implants · mean 61 months

Clinical Outcomes of Pterygoid and Maxillary Tuberosity Implants: A Systematic Review.

Raouf K, Chrcanovic BR. J Clin Med 2024. PMID 39124809

What it found: The 10-year cumulative survival rate was 92.5% for pterygoid implants and 96.9% for tuberosity implants, with failures concentrated in the first year. Implants splinted to other implants appeared to do better than unsplinted ones.

What it means for you: Anchoring far back in the upper jaw is another way round severe bone loss, usually as part of a joined bridge.

Limits: Mostly observational studies with varied follow-up.

Immediate or delayed teeth

Immediate or delayed teeth Cochrane systematic review · 26 RCTs, 1,217 participants, 2,120 implants · 4 months to 1 year

Interventions for replacing missing teeth: different times for loading dental implants.

Esposito M, Grusovin MG, Maghaireh H, Worthington HV. Cochrane Database Syst Rev 2013. PMID 23543525

What it found: Mean implant failure across all trials was 2.5%. Comparing immediate with conventional loading, there was no evidence of a difference in prosthesis failure (RR 1.87) or implant failure (RR 1.65) in the first year.

What it means for you: Teeth placed on implants straight away did not clearly do worse in the first year than waiting, in well-selected cases.

Limits: Short follow-up; many trials at high or unclear risk of bias; not only full-arch cases.

Immediate or delayed teeth Systematic review and meta-analysis · 62 studies, 2,695 patients, 13,653 implants · 1 to 15 years

Implant loading protocols for edentulous patients with fixed prostheses: a systematic review and meta-analysis.

Papaspyridakos P, Chen CJ, Chuang SK, Weber HP. Int J Oral Maxillofac Implants 2014. PMID 24660202

What it found: With careful case selection and rough-surface implants, immediate loading of fixed full-arch teeth gave similar implant and bridge survival to early and conventional loading. Estimated 1-year implant survival was above 99% for all three. Most studies recommended a minimum insertion torque of 30 Ncm for immediate loading.

What it means for you: Same-day fixed teeth depend on the implants being firm enough on the day; that is why a surgeon may decide on the day not to fit them.

Limits: Mostly cohort studies; many confounding factors.

Immediate or delayed teeth Retrospective clinical study · 44 patients, 176 implants · early results

"All-on-Four" immediate-function concept with Brånemark System implants for completely edentulous mandibles: a retrospective clinical study.

Maló P, Rangert B, Nobre M. Clin Implant Dent Relat Res 2003. PMID 12691645

What it found: Five immediately loaded implants were lost before 6 months, giving cumulative survival of 96.7% (development group) and 98.2% (routine group). Prosthesis survival was 100%.

What it means for you: The first published description of the four-implant, same-day fixed lower bridge.

Limits: Retrospective; short follow-up; developer's clinic.

Immediate or delayed teeth Retrospective cohort, one surgeon · 88 patients, 107 arches, 558 implants · 9 months

Early Complications of Immediate Loading in Edentulous Full-Arch Restorations: A Retrospective Analysis of 88 Cases.

Cercadillo-Ibarguren I, Sánchez-Torres A, Figueiredo R, Valmaseda-Castellón E. Int J Oral Maxillofac Implants 2017. PMID 28403247

What it found: 18 provisional prostheses (16.8%) fractured within nine months, more often in the upper jaw and in people who grind their teeth. 1.6% of implants failed.

What it means for you: Temporary full-arch teeth break fairly often. That is a nuisance to plan for, not usually a threat to the implants.

Limits: Single surgeon, retrospective.

Immediate or delayed teeth Expert consensus

Consensus statements and clinical recommendations on treatment indications, surgical procedures, prosthetic protocols and complications following All-On-4 standard treatment. 9th Mozo-Grau Ticare Conference in Quintanilla, Spain.

Penarrocha-Diago M, et al. J Clin Exp Dent 2017. PMID 28512551

What it found: The panel recommended an insertion torque above 35 Ncm for immediate loading and a rigid provisional bridge strong enough not to fracture. Fractures of provisional acrylic bridges were listed as the usual prosthetic complication.

What it means for you: Temporary full-arch teeth have to be stiff, because micro-movement disturbs healing.

Limits: Expert opinion; the panel itself notes the evidence is weak.

Smoking, diabetes and general health

Smoking, diabetes and general health Systematic review and meta-analysis · 107 studies, about 80,300 implants

Smoking and dental implants: A systematic review and meta-analysis.

Chrcanovic BR, Albrektsson T, Wennerberg A. J Dent 2015. PMID 25778741

What it found: 6.35% of implants in smokers failed (1,259 of 19,836) against 3.18% in non-smokers (1,923 of 60,464). Smoking significantly affected failure rates, post-operative infection and marginal bone loss.

What it means for you: Smoking roughly doubled the crude failure rate in this pooled data. Stopping before surgery is one of the most useful things a patient can do.

Limits: Uncontrolled confounding in the included studies, as the authors note.

Smoking, diabetes and general health Systematic review and meta-analysis · 14 publications

Diabetes and oral implant failure: a systematic review.

Chrcanovic BR, Albrektsson T, Wennerberg A. J Dent Res 2014. PMID 24928096

What it found: Diabetes did not significantly affect implant failure (risk ratio 1.07), but people with diabetes had slightly more marginal bone loss (mean difference 0.20 mm).

What it means for you: Diabetes is usually not a bar to implants, but control matters and bone around implants may need closer watching.

Limits: Few studies compared both groups directly; confounding factors.

Smoking, diabetes and general health Systematic review and meta-analysis · 27 studies, 12,369 implants

Bruxism and dental implants: A systematic review and meta-analysis.

Häggman-Henrikson B, Ali D, Aljamal M, Chrcanovic BR. J Oral Rehabil 2024. PMID 37589382

What it found: Implants in probable bruxers had a higher risk of failure than in non-bruxers (odds ratio 2.189). Follow-up time did not change this.

What it means for you: If you clench or grind, tell your dentist. It affects design and night-guard advice.

Limits: Bone loss could not be compared because studies did not report it separately.

Smoking, diabetes and general health Systematic review of prospective cohorts · 12 cohort studies · 1 year to over 5 years

History of periodontitis as a risk factor for implant failure and incidence of peri-implantitis: A systematic review, meta-analysis, and trial sequential analysis of prospective cohort studies.

Serroni M, Borgnakke WS, Romano L, et al. Clin Implant Dent Relat Res 2024. PMID 38720611

What it found: A history of periodontitis was linked with greater risk of implant failure (RR 2.26 beyond 5 years), more peri-implantitis (RR 4.09) and more marginal bone loss (0.75 mm on average).

What it means for you: Many full-arch patients lost their teeth to gum disease. The same tendency can affect implants, so maintenance is not optional.

Limits: Low certainty evidence (no randomised trials possible).

Smoking, diabetes and general health Retrospective cohort, one specialist clinic · 2,670 patients, 10,096 implants · 1980 to 2014

Factors Influencing Early Dental Implant Failures.

Chrcanovic BR, Kisch J, Albrektsson T, Wennerberg A. J Dent Res 2016. PMID 27146701

What it found: 176 implants (1.74%) in 139 patients were lost before abutment connection. Smoking and antidepressant intake were the significant predictors of early failure.

What it means for you: Early failures are uncommon and linked to patient factors you can tell your dentist about.

Limits: Single clinic, retrospective, long time span.

Smoking, diabetes and general health Systematic review of animal and human studies · 16 animal and 27 human studies

Relationship between vitamin D deficiency and early implant failure and osseointegration.

Miron RJ, Estrin NE, Paz A, et al. Periodontol 2000 2025. PMID 41163589

What it found: 22 of 27 human studies supported a link between adequate vitamin D and better osseointegration or fewer early failures; deficiency was associated with up to a fourfold increase in early implant failures. Only three human studies were randomised trials.

What it means for you: Checking vitamin D before implant surgery is a reasonable, low-cost step; the size of the effect is still uncertain.

Limits: Mostly retrospective and small studies; the authors call for more randomised trials.

Smoking, diabetes and general health Retrospective cohort, one private clinic · 885 patients, 1,740 implants · Early failure (first 4 months)

Low serum vitamin D and early dental implant failure: Is there a connection? A retrospective clinical study on 1740 implants placed in 885 patients.

Guido Mangano F, Ghertasi Oskouei S, Paz A, et al. J Dent Res Dent Clin Dent Prospects 2018. PMID 30443302

What it found: Early failure was 11.1% in 27 patients with vitamin D below 10 ng/mL, 4.4% at 10 to 30 ng/mL and 2.9% above 30 ng/mL. The trend was clear but not statistically significant (P = 0.105).

What it means for you: Severe deficiency may matter; the study was too small in that group to prove it.

Limits: Retrospective; only 27 severely deficient patients.

Smoking, diabetes and general health Systematic review · 7 studies, 1,462 participants, 4,450 implants

Impact of Vitamin D on Osseointegration in Dental Implants: A Systematic Review of Human Studies.

Buzatu BLR, Buzatu R, Luca MM. Nutrients 2024. PMID 38257102

What it found: Implant loss ranged from 3.9% to 11.4% across studies; the highest rate (11.1%) was in severely vitamin D-deficient patients, particularly with smoking or gum disease.

What it means for you: Points the same way as other reviews, from a small evidence base.

Limits: Seven heterogeneous studies; no pooled estimate.

Smoking, diabetes and general health Systematic review · 4 studies, 1,089 patients, 1,984 implants · 20 to 240 months

Influence of Serum Vitamin D Levels on Survival Rate and Marginal Bone Loss in Dental Implants: A Systematic Review.

Bazal-Bonelli S, Sánchez-Labrador L, Cortés-Bretón Brinkmann J, et al. Int J Environ Res Public Health 2022. PMID 36011753

What it found: Lower serum vitamin D was linked with slightly worse marginal bone loss; longer follow-up is needed to judge effects on survival.

What it means for you: A more cautious reading of the same question.

Limits: Only four studies met the criteria.

Smoking, diabetes and general health Meta-analysis

Dental implants in irradiated versus nonirradiated patients: A meta-analysis.

Chrcanovic BR, Albrektsson T, Wennerberg A. Head Neck 2016. PMID 25242560

What it found: Irradiation of the head and neck negatively affected implant survival, with a tendency to lower survival at higher radiation doses. There was no significant difference whether implants were placed before or after 12 months following radiotherapy, and the review did not support hyperbaric oxygen therapy.

What it means for you: Implants after head and neck radiotherapy are possible but need specialist planning with your oncology team.

Limits: Uncontrolled confounding factors in the included studies.

Materials and engineering

Materials and engineering Systematic review · 12 observational studies, 223 patients, 285 zirconia bridges · short term

Clinical outcomes of full arch fixed implant-supported zirconia prostheses: A systematic review.

Bidra AS, Rungruanganunt P, Gauthier M. Eur J Oral Implantol 2017. PMID 28944367

What it found: Mean failure rate was 1.4% (four bridges fractured). Prosthetic complications occurred in 16.1% of bridges, and 14.7% were minor complications limited to chipped porcelain veneering.

What it means for you: Zirconia full-arch bridges rarely break outright; when problems happen they are usually chips in the porcelain layer.

Limits: Short-term observational data; the authors say monolithic designs need long-term confirmation.

Materials and engineering Systematic review and meta-analysis · 7 full-arch studies (veneered zirconia) · 5-year estimates

Clinical outcomes of partial and full-arch all-ceramic implant-supported fixed dental prostheses. A systematic review and meta-analysis.

Pieralli S, Kohal RJ, Rabel K, von Stein-Lausnitz M, Vach K, Spies BC. Clin Oral Implants Res 2018. PMID 30306694

What it found: Veneered zirconia full-arch bridges had an estimated 5-year survival of 97.7% and supporting implants 99.4%, but the 5-year complication rate from chipped veneering ceramic was 34.8%.

What it means for you: Porcelain layered over zirconia chips often on full arches. This is one reason many labs now favour monolithic zirconia.

Limits: The authors call the chipping rate clinically unacceptable and ask for more long-term data.

Materials and engineering Systematic review (mainly experimental studies) · 100 papers

Effects of titanium surface topography on bone integration: a systematic review.

Wennerberg A, Albrektsson T. Clin Oral Implants Res 2009. PMID 19663964

What it found: Smooth (Sa under 0.5 µm) and minimally rough (0.5 to 1 µm) surfaces gave weaker bone responses than rougher ones; moderately rough surfaces (over 1 to 2 µm) did better than rough ones (over 2 µm) in some studies. Many papers described surfaces poorly.

What it means for you: Today's moderately rough implant surfaces came out of this line of research.

Limits: Largely animal and laboratory data; inconsistent surface measurements.

Materials and engineering Systematic review · 9 trials, 326 patients, 398 implants · 12 to 60 months

Clinical Outcomes of Zirconia Dental Implants: A Systematic Review.

Pieralli S, Kohal RJ, Jung RE, Vach K, Spies BC. J Dent Res 2017. PMID 27625355

What it found: Ceramic (zirconia) implant survival was 95.6% after 12 months, then an expected decrease of 0.05% a year. Mean bone loss after 12 months was 0.79 mm.

What it means for you: Zirconia implants look promising in the short term, mostly for single teeth and small bridges.

Limits: Short follow-up; few full-arch cases.

Materials and engineering Materials science review

Novel Zirconia Materials in Dentistry.

Zhang Y, Lawn BR. J Dent Res 2018. PMID 29035694

What it found: Yttria-stabilised zirconia (Y-TZP) is the strongest dental ceramic. Newer zirconias trade some strength and toughness for more translucency, for example by adding a cubic phase. Long-term failure mechanisms are not fully explained by routine lab tests.

What it means for you: 'Zirconia' is a family of materials. More see-through grades look more natural but are not as strong.

Limits: Laboratory review; no clinical outcomes.

Materials and engineering Systematic review and meta-analysis · 9 studies, 607 patients, 922 implants · 3 to 36 months

Clinical evidence on titanium-zirconium dental implants: a systematic review and meta-analysis.

Altuna P, Lucas-Taulé E, Gargallo-Albiol J, Figueras-Álvarez O, Hernández-Alfaro F, Nart J. Int J Oral Maxillofac Surg 2016. PMID 26852292

What it found: Narrow titanium-zirconium implants had mean survival and success of 98.4% and 97.8% at one year and 97.7% and 97.3% at two years, with mean bone loss of 0.36 mm at one year and 0.41 mm at two years.

What it means for you: The stronger titanium-zirconium alloy performs well in narrow implants in the short term.

Limits: Short follow-up; narrow implants only; one manufacturer's alloy.

Materials and engineering Animal experiment · 6 miniature pigs, 6 surfaces · 3 and 6 weeks

Influence of surface characteristics on bone integration of titanium implants. A histomorphometric study in miniature pigs.

Buser D, Schenk RK, Steinemann S, Fiorellini JP, Fox CH, Stich H. J Biomed Mater Res 1991. PMID 1918105

What it found: Electropolished and fine-sandblasted surfaces had 20–25% bone-to-implant contact; large-grit sandblasted and plasma-sprayed 30–40%; sandblasted and acid-etched (large grit) 50–60%; hydroxyapatite-coated 60–70%, but the coating showed signs of resorption.

What it means for you: This experiment is the origin of the sandblasted, acid-etched surface used on many implants today.

Limits: Animal study; early healing only; bone contact is not the same as clinical success.

Materials and engineering Systematic review and meta-analysis, 13 studies · 2,841 prostheses, 3,940 implants · 12 to 62 months

Are monolithic zirconia complete arch implant-supported prostheses reliable? A systematic review and meta-analysis.

Matos ACM, Vieira FL, Marrara JR, Tirapelli C, Correia FD, Santiago-Junior JF. J Prosthet Dent 2026. PMID 41813561

What it found: 99% of monolithic zirconia full-arch prostheses were still in function at last follow-up (95% CI 97% to 100%). Pooled technical complication rate was 14%; veneered designs had up to 27% complications against 1% to 3% for monolithic designs.

What it means for you: Unlayered zirconia arches did very well over roughly one to five years. Layered porcelain on top is where most of the trouble sits.

Limits: Mostly retrospective studies; the authors rated the certainty of the evidence as low.

Materials and engineering Network meta-analysis of randomised trials · RCTs published 2009 to 2020 · 12 months after loading

Comparison of external, internal flat-to-flat, and conical implant abutment connections for implant-supported prostheses: A systematic review and network meta-analysis of randomized clinical trials.

Camps-Font O, Rubianes-Porta L, Valmaseda-Castellón E, Jung RE, Gay-Escoda C, Figueiredo R. J Prosthet Dent 2023. PMID 34776267

What it found: Conical connections showed significantly less marginal bone loss and fewer prosthetic complications than external hexagon connections. Connection type did not change implant survival or biological complication rates.

What it means for you: The joint between implant and abutment affects bone levels and screw problems a little, but not whether the implant survives in the first year.

Limits: Only one year after loading.

Materials and engineering Multicentre laboratory study · frameworks tested at three university sites · laboratory

Volumetric determination of the amount of misfit in CAD/CAM and cast implant frameworks: a multicenter laboratory study.

Drago C, et al. Int J Oral Maxillofac Implants 2010. PMID 20862405

What it found: CAD/CAM implant frameworks fitted significantly better onto the implants than frameworks cast with the lost-wax technique.

What it means for you: Milling a framework from a solid block gives a more accurate fit than casting molten metal.

Limits: Laboratory study, not patients.

Materials and engineering In vitro study · titanium and zirconia frameworks on 4 implants · laboratory

In vitro fit of CAD-CAM complete arch screw-retained titanium and zirconia implant prostheses fabricated on 4 implants.

Al-Meraikhi H, et al. J Prosthet Dent 2018. PMID 28720339

What it found: Titanium and zirconia CAD-CAM frameworks fitted equally well. All three-dimensional gaps measured under 135 micrometres, but absolute passive fit was not achieved.

What it means for you: Even milled frameworks are not perfect; the aim is a misfit small enough that the screws and bone are not strained.

Limits: Laboratory model.

Materials and engineering Systematic review and meta-analysis · 25 studies, 2,083 patients, 4,017 implants · 7 studies over 60 months

Clinical outcomes of zirconia implants: a systematic review and meta-analysis.

Mohseni P, Soufi A, Chrcanovic BR. Clin Oral Investig 2023. PMID 38135804

What it found: 10-year cumulative survival was 95.1%. 172 implants failed, 26 of them by fracture (mostly narrow implants). Two-piece implants survived less well than one-piece implants.

What it means for you: Zirconia implants perform well in the studies available, but have far less data than titanium.

Limits: Mostly single crowns and short bridges; few full-arch cases.

Materials and engineering Systematic review and evidence map · 45 reports in 24 study families

Factor-specific clinical evidence for zirconia dental implants: A systematic review and evidence map.

Son K, Lee KB. J Dent 2026. PMID 42810637

What it found: No factor-specific result was independently replicated, so no validated zirconia-specific rule for prognosis or treatment choice could be established.

What it means for you: Claims that one zirconia implant design is better than another are not yet backed by replicated evidence.

Limits: Not prospectively registered; maps evidence rather than pooling it.

Materials and engineering Animal study (dogs) · 20 dogs, 160 devices · 2 hours to 12 weeks

De novo alveolar bone formation adjacent to endosseous implants.

Berglundh T, Abrahamsson I, Lang NP, Lindhe J. Clin Oral Implants Res 2003. PMID 12755774

What it found: New bone began forming in the first week. Between weeks 1 and 2 the bone that gave the screw its initial grip was partly resorbed and replaced with new bone, yet the implants stayed clinically stable throughout.

What it means for you: Healing swaps mechanical grip for biological attachment, which explains the vulnerable window a few weeks after surgery.

Limits: Animal model with a specially designed implant; human timelines differ.

Materials and engineering Prospective clinical study · 20 patients, 27 implants · 10 weeks

Resonance frequency measurement of implant stability in vivo on implants with a sandblasted and acid-etched surface.

Barewal RM, et al. Int J Oral Maxillofac Implants 2003. PMID 14579951

What it found: Measured implant stability was lowest at 3 weeks in all bone types. Soft (type 4) bone showed the largest drop (8.6%) and the largest recovery afterwards (26.9% from week 3 to week 10).

What it means for you: The dip in stability is a normal part of healing, and it is deepest in soft bone.

Limits: Small study of single implants in the back of the jaws.

Materials and engineering Systematic review (mostly case reports) · 9 studies, 21 patients, 33 implants

Titanium hypersensitivity in dental implants: A systematic review of updated clinical evidence and diagnostic strategies.

Restelli L, et al. J Prosthodont Res 2026. PMID 41581901

What it found: Out of 1,761 records only 9 studies qualified; 20 implants were diagnosed as titanium hypersensitivity cases and 17 needed removal. The authors describe the condition as rare but clinically relevant.

What it means for you: True titanium allergy is rare. If you have reacted to metals before, say so; there is no single reliable test yet.

Limits: Case reports only; diagnosis methods were not standardised.

Materials and engineering Retrospective laboratory records study · 2,039 prostheses · 5 years

Survival of 2039 complete arch fixed implant-supported zirconia prostheses: A retrospective study.

Bidra AS, et al. J Prosthet Dent 2018. PMID 28689903

What it found: Mainly monolithic zirconia bridges with porcelain only on the gum area had a 5-year cumulative survival of 99.3%; six fractured. No prostheses came back for chipping of the gum porcelain.

What it means for you: Keeping porcelain off the biting surfaces seems to remove most chipping.

Limits: Data from one laboratory's warranty returns; many prostheses had less than 3 years of service.

Materials and engineering Systematic review · 12 articles, 119 prostheses · 1 to 6 years

Complete-arch implant-supported fixed dental prostheses fabricated with PEEK and PEKK framework: a systematic review.

Mishra SK, et al. Evid Based Dent 2023. PMID 37674039

What it found: PEEK-framework full-arch bridges had 97.3% cumulative survival at short follow-up. Debonding (adhesion) of the veneering was the most common problem.

What it means for you: High-performance polymers are a newer, lighter framework option with limited long-term data.

Limits: Small numbers and short follow-up; very little data on PEKK.

Materials and engineering Systematic review · 10 clinical studies · at least 6 months

Prosthesis wear and complications in various materials used for fixed implant-supported prostheses: A systematic review.

Sanz E, et al. J Prosthet Dent 2026. PMID 41991355

What it found: Wear-related problems (severe wear, chipping, screw loosening, framework fracture) were reported more often in metal-acrylic full-arch bridges. Grinding without a night guard was often linked to more complications.

What it means for you: Acrylic teeth wear; if you grind, a night guard matters whatever the material.

Limits: Few studies measured wear directly.

Materials and engineering Systematic review of laboratory studies · 16 studies

Impact of repeated tightening and loosening on the implant-prosthetic screw joint: A systematic review and meta-analysis.

Shui Y, et al. J Dent 2026. PMID 41203042

What it found: Repeated tightening and loosening reduced the torque needed to remove the screw, with significant loss after 5 cycles and visible wear and deformation after 10.

What it means for you: Screws are wear parts; replacing them rather than reusing them indefinitely is a reasonable habit.

Limits: Laboratory data with high heterogeneity.

Materials and engineering Systematic review of laboratory studies · 10 studies

Effect of three-dimensional print angle on integrity of interim crowns: A systematic review.

Lins LBC, et al. J Prosthet Dent 2025. PMID 39181773

What it found: A 45-degree print angle gave the best fit in most studies; flexural strength results varied widely between studies.

What it means for you: How a printed temporary is made changes its properties, not only the resin chosen.

Limits: In-vitro crowns, not full-arch bridges.

Materials and engineering Laboratory study · 64 specimens · 30 days immersion

Comparative Analysis of Color Stability among 3D-Printed Resin-Based, CAD/CAM, and Conventional Interim Fixed Prosthodontic Materials.

Alshamrani SA, Alobaid BF, Alharkan HM. J Pharm Bioallied Sci 2024. PMID 40061670

What it found: Bis-acryl and 3D-printed interim materials discoloured most, with coffee and tea staining worst. Milled CAD/CAM PMMA and conventional PMMA stayed within clinically acceptable colour change.

What it means for you: Temporary teeth can stain in months; milled PMMA held its colour best in this test.

Limits: Small laboratory study on discs, not on worn bridges.

Eating, comfort and quality of life

Eating, comfort and quality of life Consensus statement

The McGill consensus statement on overdentures. Mandibular two-implant overdentures as first choice standard of care for edentulous patients.

Feine JS, Carlsson GE, Awad MA, et al. Gerodontology 2002. PMID 12164236

What it found: An international expert group stated that a lower denture held by two implants should be the minimum first-choice standard of care for people with no lower teeth.

What it means for you: Even when fixed teeth are not possible or affordable, two lower implants under a denture make a large difference.

Limits: Consensus opinion; no abstract on PubMed.

Eating, comfort and quality of life Narrative review

The impact of edentulism on oral and general health.

Emami E, de Souza RF, Kabawat M, Feine JS. Int J Dent 2013. PMID 23737789

What it found: Reviews the pathways linking tooth loss to general health and quality of life, and describes edentulism as a major public health problem worldwide.

What it means for you: Losing all your teeth is a health issue, not only a cosmetic one.

Limits: Narrative review without pooled numbers.

Eating, comfort and quality of life Crossover trial · 13 patients · 2 months with each prosthesis

Within-subject comparisons of maxillary fixed and removable implant prostheses: Patient satisfaction and choice of prosthesis.

Heydecke G, Boudrias P, Awad MA, De Albuquerque RF, Lund JP, Feine JS. Clin Oral Implants Res 2003. PMID 12562375

What it found: Patients wore a fixed upper implant bridge and a removable upper implant overdenture in turn. They rated the removable overdenture higher for general satisfaction, speech and ease of cleaning; nine chose to keep it and four chose the fixed bridge.

What it means for you: Fixed is not automatically better for everyone, especially in the upper jaw. Speech and cleaning count.

Limits: Very small study, short wear periods, older designs.

Eating, comfort and quality of life Meta-analysis of RCTs · 7 trials (8 publications pooled)

Impact of implant support for mandibular dentures on satisfaction, oral and general health-related quality of life: a meta-analysis of randomized-controlled trials.

Emami E, Heydecke G, Rompré PH, de Grandmont P, Feine JS. Clin Oral Implants Res 2009. PMID 19515032

What it found: Lower implant overdentures were rated more satisfactory than new conventional dentures at a clinically relevant level (pooled effect size 0.80, 95% CI 0.36–1.24), with high heterogeneity. The pooled effect on oral health-related quality of life was not statistically clear (-0.41, 95% CI -1.02 to 0.20).

What it means for you: People are more satisfied with implant-retained lower dentures than with new ordinary dentures, but how much quality-of-life scores change is uncertain.

Limits: Few trials, high heterogeneity, removable overdentures rather than fixed bridges.

Eating, comfort and quality of life Randomised crossover trial · 15 patients · two months with each design

Within-subject comparisons of implant-supported mandibular prostheses: choice of prosthesis.

Feine JS, de Grandmont P, Boudrias P, Brien N, LaMarche C, Taché R, Lund JP. J Dent Res 1994. PMID 8006238

What it found: After trying both a fixed and a removable lower implant prosthesis, 8 people chose the fixed one and 7 the removable. Both groups rated stability and chewing better with the fixed design; those choosing the removable put ease of cleaning first.

What it means for you: Given the choice after wearing both, people split almost evenly. Personal priorities decide which design feels better.

Limits: Very small; lower jaw only; 1990s designs.

Eating, comfort and quality of life Questionnaire development study · 1,217 people aged 60+ (South Australia)

Derivation and validation of a short-form oral health impact profile.

Slade GD. Community Dent Oral Epidemiol 1997. PMID 9332805

What it found: A 14-question version of the 49-item Oral Health Impact Profile (OHIP-14) explained 94% of the variance of the full version, had high reliability (alpha 0.88) and covered all seven dimensions.

What it means for you: OHIP-14 is the questionnaire most implant studies use to measure how teeth affect daily life.

Limits: Developed in older Australians; scores need context to interpret.

Eating, comfort and quality of life Randomised cross-over trial · 77 participants · 30 days each way

Effects of nocturnal wearing of dentures on the quality of sleep and oral-health-related quality in edentate elders with untreated sleep apnea: a randomized cross-over trial.

Emami E, Lavigne G, Feine JS, et al. Sleep 2021. PMID 33955479

What it found: Wearing dentures at night changed the apnoea-hypopnoea index by only 1.0 event per hour (not significant); respiratory arousals were 2.3 per hour higher with dentures in, and psychological discomfort was higher.

What it means for you: Supports the usual advice to take removable dentures out at night, even with sleep apnoea.

Limits: Untreated sleep apnoea only; one month per condition.

Eating, comfort and quality of life Meta-analysis of RCTs · 3 trials, 123 participants

Nocturnal wearing of complete dentures and obstructive sleep apnea: A meta-analysis.

Jurel SK, Bakrolwala HA, Chand P, et al. J Indian Prosthodont Soc 2024. PMID 40227935

What it found: No evidence of a difference in apnoea-hypopnoea index, sleep quality (PSQI) or daytime sleepiness (ESS) with or without dentures at night.

What it means for you: Removable dentures at night are not a treatment for sleep apnoea.

Limits: Only three small trials.

Eating, comfort and quality of life Scoping review · 4 studies (2 case reports, 1 case series, 1 finite element analysis)

Clinical considerations for oral appliance use in obstructive sleep apnea patients with dental implants: a scoping review.

Miura KI, Sakamoto Y, Yoshimine H, et al. Sleep Breath 2026. PMID 42667470

What it found: Implant-retained mandibular advancement appliances and overdentures worn in sleep were reported, with improved retention, but evidence is sparse and long-term safety data are limited.

What it means for you: Oral appliances for sleep apnoea can sometimes be adapted around implants, but this is largely uncharted.

Limits: Very few, low-level studies.

Eating, comfort and quality of life Cohort study · 172 enrolled, 153 followed up · 1 year

The nocturnal use of complete dentures and sleep stability in edentulous elders.

Emami E, Salah MH, Rompré P, et al. J Dent 2013. PMID 23751879

What it found: Sleep quality scores were stable over a year; those wearing dentures at night had poorer daytime sleepiness scores in the unadjusted model, which was not significant after adjustment.

What it means for you: Wearing dentures overnight has little effect on sleep quality in people without diagnosed apnoea.

Limits: Questionnaire-based; no sleep studies.

Eating, comfort and quality of life Review

Jet lag: trends and coping strategies.

Waterhouse J, Reilly T, Atkinson G, Edwards B. Lancet 2007. PMID 17398311

What it found: Jet lag is caused mainly by the body clock being mistimed in the new time zone; advice differs for travellers flying in different directions and crossing several time zones.

What it means for you: Planning rest and light exposure around a long flight is worth doing before any surgery.

Limits: Narrative review.

Scans, planning and radiation

Scans, planning and radiation Meta-analysis of dosimetry studies · 20 studies + 9 scanners

Effective dose of dental CBCT-a meta analysis of published data and additional data for nine CBCT units.

Ludlow JB, Timothy R, Walker C, et al. Dentomaxillofac Radiol 2015. PMID 25224586

What it found: Mean adult effective doses with standard settings were 212 µSv for large fields of view, 177 µSv for medium and 84 µSv for small. Reported adult doses for any protocol ranged from 5 to 1,073 µSv, with large differences between machines.

What it means for you: The dose of a dental CBCT depends heavily on the machine and the size of the area scanned. A full-arch plan usually needs a medium or large field.

Limits: Dose estimates, not health outcomes.

Scans, planning and radiation In vitro study · Steel reference model

Accuracy of complete-arch dental impressions: a new method of measuring trueness and precision.

Ender A, Mehl A. J Prosthet Dent 2013. PMID 23395338

What it found: On a model with teeth, conventional impressions had a trueness of 20.4 µm and precision of 12.5 µm; digital impressions were less accurate, with trueness of 58.6 µm and precision of 32.4 µm.

What it means for you: Early intraoral scanners struggled most over a whole arch; scanners have improved since.

Limits: Laboratory model with natural teeth, not implants; 2013-era scanners.

Scans, planning and radiation Systematic review of in vitro studies · 8 studies

Influence of implant position on the accuracy of intraoral scanning in fully edentulous arches: A systematic review.

Carneiro Pereira AL, Medeiros VR, da Fonte Porto Carreiro A. J Prosthet Dent 2021. PMID 33268069

What it found: Five studies found smaller deviations with digital scans than conventional impressions, two found larger and one no difference. The authors advise caution when implants are angled more than 15 degrees to each other.

What it means for you: Digital scanning of implant arches is considered reliable, with extra care for strongly angled implants.

Limits: No clinical studies; laboratory models only.

Scans, planning and radiation In vitro study · Six-implant maxillary model, 10 recordings per system

Accuracy of complete-arch implant positions recorded by analog impressions, intraoral scanning, and extraoral and intraoral photogrammetry.

Lee R, Littlefair D, Howes D. J Prosthodont 2026. PMID 42855886

What it found: Mean deviations were 101 µm for intraoral scanning, 43 µm for analogue impressions, 62 µm for extraoral photogrammetry and 15 µm for intraoral photogrammetry.

What it means for you: Photogrammetry can record implant positions across a full arch at least as accurately as traditional impressions in the laboratory.

Limits: Single laboratory model with parallel implants; not a clinical study.

Scans, planning and radiation Retrospective multicentre study · 35 patients, 52 full-arch prostheses, 221 implants · mean 12.1 months

Clinical accuracy and short-term outcomes of intraoral photogrammetry for complete-arch implant rehabilitation: A retrospective multicentre study on 35 patients.

Stefanović M, Marković A, Todorović A, et al. J Dent 2026. PMID 42462802

What it found: Passive fit was achieved in all 52 definitive prostheses. Implant survival was 99.5% and prosthesis survival 100% over about a year.

What it means for you: Early clinical data for photogrammetry-based full-arch workflows are encouraging.

Limits: Retrospective, short follow-up, one photogrammetry system.

Scans, planning and radiation Systematic review and meta-analysis of CBCT studies · 63 studies, 13,743 participants

Prevalence and extension of the anterior loop of the mental nerve in different populations and CBCT imaging settings: A systematic review and meta-analysis.

Hadilou M, Gholami L, Ghojazadeh M, Emadi N. Imaging Sci Dent 2022. PMID 35799963

What it found: An anterior loop of the nerve was seen in 40.6% of people, with an average length of 2.39 mm. The authors suggest a 2 mm safety margin from such structures when planning on CBCT.

What it means for you: The nerve can run further forward than the opening in the bone suggests, which is why 3D scans are used before lower-jaw implants.

Limits: Measurements vary between populations and scanner settings.

Common questions

Who chose these studies?

The Precious Dental editorial team chose them, and our implant surgeon reviewed the summaries. We picked systematic reviews, consensus reports, Cochrane reviews and the long-running cohort studies that dentists cite most often for full-arch treatment. We are a clinic, so read the disclosure and judge the selection for yourself.

Why do the percentages differ between studies?

Because the studies measure different things: implant survival or success, one jaw or both, five years or twenty, healthy volunteers or everyday patients. Some count people who dropped out and some do not. Our survival data page shows how much the method alone can move a headline figure.

Can I read the full papers?

Every card links to PubMed, which shows the abstract and usually a link to the publisher. Some papers are free to read; others sit behind a paywall. A public or university library can often get a copy for you.

Do these results apply to treatment at Precious Dental?

They describe what happened in the patients those researchers treated. No clinic can promise the same numbers for you. What the studies do tell you is which factors matter, such as smoking, cleaning, regular maintenance and the material of the bridge, and which questions to ask.

How often is the library updated?

We review it when an important new systematic review or consensus report appears and at least once a year. Corrections are logged on our corrections page.

Sources

1. PubMed (US National Library of Medicine)

Checked October 2026. Where we give our own view as a clinic, we say so.