Oral Implantology Risk Prediction Index and its Clinical Application

Objectives: To design an index to predict risk and likelihood of complications in oral implantology, adjust it and produce the final version suggested, after its application in a clinical case series.
Methods: Protocol was approved by the Ethics Committee. The original index was applied to 25 patients (70 implants). The outcomes, suggestions and observations of clinicians and experts permitted to re-design it, in order to provide a final version. The acceptable risk limits were adjusted to medians obtained, except for systemic risk. The scores assigned to each variable in a range of 0 to 5 points reflect the importance assigned to each item at the literature review realized. As the scores are ordinal data, non-parametric ordinal statistics was applied. The unit of analysis for systemic level was a patient and for the other levels of assessment was an implant.
Results: The study allowed the detection of critical risk aspects, excluding those that had a median equal zero. The original version was simplified and its scope was limited to the diagnostic stage. This index emphasizes medical systemic risks. The higher the total score or partial score for a level, higher was the risk and complexity of the planned treatment. The final scores suggested to assess the risk as acceptable were: TOTAL RISK: ACCEPTABLE: < 35, (A. Systemic Risk: Acceptable < 10; B. Periodontal risk: Acceptable < 8; C. Bone Risk: Acceptable < 5; D. Extraction cases Risk: Acceptable < 9; E. Risk associated to protocol of treatment suggested: Acceptable < 5; F. Esthetic Risk: Acceptable < 6.
Conclusions: Index designed to evaluate risk and complexity of treatment, is multilevel and clinically useful, easy to understand and fill in, applicable to different sorts of clinics related to Oral Implantology. The index should be validated in a multi-institutional population and must be updated according to technological developments.