Long Term Implant Success Evaluation

Objectives: In 1986, Albrektsson et al. suggested implant success criteria regarding, among other parameters, marginal bone loss. These criteria are still frequently referred to as the “gold standard” for implant success. However, recently the abundance of data regarding marginal bone loss, and a better understanding of bone and soft tissue behavior around the implant neck and body, have shown these criteria to be inaccurate for the wide variety of implant systems. The purpose of this article is to review some of the relevant available literature as to the knowledge regarding marginal bone loss and to propose guidelines for a novel approach for evaluating the long-term success of implants with regards to marginal bone loss. Methods: The English language relevant available literature as to the knowledge regarding marginal bone loss was reviewed using the Pub-Med index. Guidelines for a novel approach for evaluating the long-term success of implants was proposed based on our clinical experience as well as on the relevant literature. Results: Four hypothetical patterns of implant marginal bone loss after the first year are suggested: low rate marginal bone loss over the years (Albrektsson's pattern); low rate marginal bone loss in the first few years followed by a rapid loss of bone support; high rate marginal bone loss in the first few years followed by almost no bone loss; and a continuous high rate marginal bone loss leading to complete loss of bone support. Conclusions: Universal success criteria for long term implant success evaluation should be revised.