A cross sectional study of dental implant service provision in British and Irish dental hospitals.

Abstract

Introduction There are multiple ways in which treatment using dental implants is provided in a secondary care setting, not only in terms of the groups of patients treated, but also the clinicians who provide that care.Methods An online survey was circulated to speciality registrars in restorative dentistry in all UK dental hospitals and to postgraduate students in prosthodontics in the Republic of Ireland, consisting of nine questions aimed at understanding which patient groups are treated using dental implants in a hospital setting, how cases are planned, executed and to explore the underlying reasons for each unit's method of provision.Results Completed surveys were received from 67% of dental hospitals in Britain and Ireland. Treatment planning was undertaken by the restorative team alone in 64% of units in patients with hypodontia, 57% with trauma and 71% with an atrophic edentulous ridge and by a multi-disciplinary team in 50% of units for patients with cleft lip and palate (CLP) and 45% with head and neck (H&N) cancer. The restorative team place all or most of the implant fixtures in 50% of units in patients with CLP, 71% in trauma patients, 71% in hypodontia patients, 64% in edentulous patients and 43% in H&N oncology patients. Stents are produced and used by the restorative team in 64% of units for edentulous patients, 79% of patients with hypodontia, 79% of those suffering trauma, 58% of CLP patients and 50% of patients with H&N cancer. Twenty-one percent of responding units had stents made by the restorative team and used by the surgical team. The median percentage of implant-supported restorations that are screw retained is 90% (SD: 4.93, range: 25-95%) and the median percentage of zirconia abutments being used is 22.5% (SD: 5.24, range: 0-50%). Use of zygomatic implants varies hugely between responding units with 43% of them not placing any zygomatic implants.Conclusions There is a wide range of protocols and team members involved in the provision of dental implant rehabilitations throughout the British Isles reflecting the lack of any single evidence-based approach. A multi-disciplinary team approach with the restorative dentist as a key member is likely to yield the most favourable long term outcomes.