Objectives

A retrospective assay of dental implants placed in private dental practices in Victoria(Australia) over a 5-year period from 2005 was performed: this paper documents the practices of practitioners with regards to augmentation procedures performed in conjunction with dental implants and reflects on them with reference to the literature.

Methods

The study was advertised via professional forums to maximize awareness/uptake. Data was extracted from patient files of recruited practitioners who met the inclusion criteria, via an anonymised proforma, by trained research assistants. Information collected included frequency, timing and materials in particulate and onlay-grafting, open/closed sinus lifting, socket preservation and connective-tissue grafting. Descriptive statistics were obtained via IBM SPSS Statistics.

Results

8486 implants were placed: 2282(26.9%) required ≥1 hard-tissue procedure. There were 484(5.7%) soft-tissue procedures. The most common augmentation procedure was particulate grafting (1820(21.4% of implants)). 931(35.9%) hard-tissue procedures used a barrier membrane. 75.9% of membranes were Bio-gide™. Bio-Oss  and autogenous bone were the most commonly used materials in all augmentation techniques. 1148(63.1%) particulate-grafted sites had simultaneous, single-stage implants placed; 92.9% onlay grafts and 83.7% open sinus lifts had a healing period before implant placement. The mean overall healing period was 194 days (6.5 months). The anterior maxilla was the most common site for all augmentation procedures.

Conclusions

Augmentation procedures were required for nearly 1/3 of implants placed. Over 20% were particulate grafts. Other hard-tissue procedures and connective-tissue grafts featured strongly. It is clear that augmentation procedures have a major influence on dental implant rehabilitation. A future paper will demonstrate any associations between these practices and complications/implant outcome. There is little data in the literature to demonstrate such features of augmentation practice in these large numbers and in such a diverse group of independent practitioners and patients, although the practices observed are largely in keeping with the internationally-published evidence-base.