implant success, survival, and failure: the international ... · §§faculty, department of oral...

Implant Success, Survival, and Failure:The International Congress of Oral

Implantologists (ICOI) PisaConsensus Conference

Carl E. Misch, DDS, MDS,* Morton L. Perel, DDS, MScD,† Hom-Lay Wang, DDS, MScD,‡Gilberto Sammartino, MD, DDS,§ Pablo Galindo-Moreno, DDS, PhD,� Paolo Trisi, DDS,¶ Marius Steigmann, Dr. Med,#

Alberto Rebaudi, MD, DDS,** Ady Palti, DDS,†† Michael A. Pikos, DDS,‡‡ D. Schwartz-Arad, DMD, PhD,§§Joseph Choukroun, MD,�� Jose-Luis Gutierrez-Perez, MD, PhD, DDS,¶¶ Gaetano Marenzi, DMD, DDS,##

and Dimosthenis K. Valavanis, MD, DDS, DMD***

Success criteria for endosteal im-plants have been proposed previ-ously by several authors1–6 The

report by Albrektsson et al4 is widelyused today. However, it does not con-sider the amount of crestal bone lostduring the first year. In addition, successrates suggested in this guideline describean ideal implant quality of health for astudy or clinical report, but does notaddress individual implants that mayhave a stable condition in the mouthafter a brief episode of bone loss.

The success criterion most com-monly reported in clinical reports is

the survival rate, meaning whether theimplant is still physically in the mouthor has been removed.7 Proponents ofthis method say it provides the clearestpresentation of the data. Critics arguethat implants that should be removedbecause of pain or disease may bemaintained and are wrongfully re-ported as being successful.

A natural tooth is not described inthe literature as clinical success or fail-ure. Instead, ideal conditions for atooth are reported, and a quality ofhealth scale is used to describe in-traoral clinical conditions. In 1993, animplant quality of health scale wasestablished by James and further de-veloped by Misch.8,9 On 5th October,

2007, a Pisa, Italy Consensus Confer-ence (sponsored by the InternationalCongress of Oral Implantologists)modified the James–Misch HealthScale and approved 4 clinical categorythat contain conditions of implant suc-cess, survival, and failure. Survivalconditions for implants may have 2different categories: satisfactory sur-vival describes an implant with lessthan ideal conditions, yet does not re-quire clinical management; and compro-mised survival includes implants withless than ideal conditions, which requireclinical treatment to reduce the risk ofimplant failure. Implant failure is theterm used for implants that require re-moval or have already been lost.

*Professor and Director of Oral Implantology, Department ofPeriodontology and Implant Dentistry, Temple Dental School,Philadelphia, PA.†Private Practice, Providence, RI; Visiting Faculty, BostonUniversity, Goldman School for Dental Medicine, Boston, MA.‡Professor and Director of Graduate Periodontics, Departmentof Periodontics and Oral Medicine, School of Dentistry,University of Michigan, Ann Arbor, MI.§Professor of Oral and Maxillofacial Surgery, Faculty ofMedicine, Head of Department of Oral Surgery, University ofNaples “Federico II”, Naples, Italy.�Associate Professor, Oral Surgery and Implant DentistryDepartment, University of Granada, Spain.¶Private Practice, Pescara, Italy; Scientific Director of Bio.C.R.A Biomaterials Clinical Research Association, Pescara,Italy; Director Biomaterial Research Laboratory, InstitutoOrtopedico Galeazzi, Milano, Italy.#Private Practice, Neckargemund, Germany; Adjunct AssistantProfessor, Boston University, Boston, MA.**Assistant Professor, University of Genova, Italy; VicePresident of Bio. C.R.A. Biomaterials Clinical ResearchAssociation, Pescara, Italy; Private Practice, Italy.††Private Practice, Baden-Baden, Germany; Clinical Professor, NewYork University, College of Dentistry, New York, NY.‡‡Private Practice, Palm Harbor, FL.§§Faculty, Department of Oral and Maxillofacial Surgery, TheMaurice and Gabriela Goldschleger School of Dental Medicine,Tel Aviv University, Tel Aviv, Israel.��Private Pain Clinic, Nice, France.¶¶Dean and Professor of Oral and Maxillofacial Surgery, UniversityHospital, School of Dentistry, University of Seveille, Spain.##Clinical Assistant, Department of Oral and MaxillofacialSciences, University of Naples (Federico II).***Private practice, Athens, Greece.

ISSN 1056-6163/08/01701-005Implant DentistryVolume 17 • Number 1Copyright © 2008 by Lippincott Williams & Wilkins

DOI: 10.1097/ID.0b013e3181676059

The primary function of a dentalimplant is to act as an abutment fora prosthetic device, similar to a nat-ural tooth root and crown. Any suc-cess criteria, therefore, must includefirst and foremost support of a func-tional prosthesis. In addition, al-though clinical criteria for prostheticsuccess are beyond the scope of thisarticle, patient satisfaction with theesthetic appearance of the implant res-toration is necessary in clinical practice.

The restoring dentist designs andfabricates a prosthesis similar to onesupported by a tooth, and as such of-ten evaluates and treats the dental im-plant similarly to a natural tooth. Yet,fundamental differences in the support

system between these entities shouldbe recognized. The purpose of this ar-ticle is to use a few indices developedfor natural teeth as an index that isspecific for endosteal root-form im-plants. This article is also intended toupdate and upgrade what is purportedto be implant success, implant sur-vival, and implant failure. The HealthScale presented in this article wasdeveloped and accepted by the Inter-national Congress of Oral Implantolo-gists Consensus Conference for ImplantSuccess in Pisa, Italy, October 2007.(Implant Dent 2008;17:5–15)Key Words: implant clinical suc-cess, implant clinical survival, im-plant clinical failure

IMPLANT DENTISTRY / VOLUME 17, NUMBER 1 2008 5

The term implant success may beused to describe ideal clinical condi-tions. It should include a time periodof at least 12 months for implantsserving as prosthetic abutments. Theterm early implant success is sug-gested for a span of 1 to 3 years,intermediate implant success for 3 to 7years, and long-term success for morethan 7 years. The implant success rateshould also include the associatedprosthetic survival rate in a clinicalreport.

CLINICAL INDICES

Periodontal indices are often usedfor the evaluation of dental im-plants.10,11 Periodontal indices, ofthemselves, do not define implant suc-cess or failure. These clinical indicesmust be related to other factors such asexudate or overloading of the prosthe-sis. However, understanding the basisof a few clinical indices for evaluationallows these criteria to establish ahealth-disease implant quality scalerelated to implant therapy.

Pain

Most clinical implant positions inthe literature do not invade the struc-tures of the infraorbital or inferior al-veolar nerves. Therefore, in thesuccess-to-failure criteria, it is as-sumed that the implant does not vio-late the major nerves of the jaws.12,13

Subjective findings of pain or tender-ness associated with an implant bodyare more difficult to assess than theseconditions with natural teeth.

Once the implant has achievedprimary healing, absence of pain un-der vertical or horizontal forces is aprimary subjective criterion. Painshould not be associated with the im-plant after healing. When present, it ismore often an improper fitting pros-thetic component, or pressure on thesoft tissue from the prosthesis. Percus-sion and forces up to 500 g (1.2 psi)may be used clinically to evaluate im-plant pain or discomfort. Percussion isused for the impact force to the im-plant, not for the audible effect asso-ciated with integration. Usually, painfrom the implant body does not occurunless the implant is mobile and sur-rounded by inflamed tissue or hasrigid fixation but impinges on a nerve.

Pain during function from an implantbody is a subjective criterion thatplaces the implant in the failure cate-gory. Sensitivity from an implant dur-ing function may place the implant inthe survival criteria, and may warrantsome clinical treatment.

Mobility

Rigid fixation is a clinical term forimplants, which describes the absenceof observed clinical mobility with ver-tical or horizontal forces under 500 g,similar to evaluating teeth. Osseointe-gration is a histologic term defined asthe surrounding bone in direct contactwith an implant surface at the magni-fication of a light microscope.12 Overthe years, rigid fixation and osseointe-gration have been used interchange-ably. Today, the clinical term “lack ofmobility” may be used to describe im-plant movement, and is a clinical con-dition most often used to determine asto whether the implant is integrated. Aroot-form implant supported prosthe-sis is most predictable with this type ofsupport system.

Lack of clinical movement does notmean the true absence of mobility. Ahealthy implant may move less than 75�m; yet, it appears as zero clinical mo-bility.14 Clinical lack of implant mobilitydoes not always coincide with a directbone–implant interface.3 However,when observed clinically, lack of mobil-ity usually means that at least a portionof the implant is in direct contact withbone, although the percentage of bonecontact cannot be specified.15 A clini-cally mobile implant indicates the pres-ence of connective tissue between theimplant and bone, and suggests clinicalfailure for an endosteal root-formimplant. Implant “mobility” may be as-sessed by computer or various instru-ments,16,17 but at this point in timethese instruments are not necessary todetermine clinical movement in a hor-izontal or vertical direction as beingimplant failure.

Radiographic Crestal Bone Loss

The marginal bone around the im-plant crestal region is usually a signif-icant indicator of implant health. Thelevel of the crestal bone may be mea-sured from the crestal position of theimplant at the initial implant surgery.The most common method (in the lit-

erature) to asses bone loss after heal-ing is by radiographic evaluation. Ofcourse, conventional radiographicsonly monitor the mesial or distal as-pect of bone loss around the implantbody.

Several studies report yearly ra-diographic marginal bone loss afterthe first year of function in the rangeof 0 to 0.2 mm.18–20 The marginal boneloss for the quality of health scaleshould include the first year. Althoughthere are many different aspects thatcontribute to early bone loss, regard-less of the cause the overall amount ofbone loss may affect clinical criteria ofsuccess to failure. Clinical studies of-ten report statistical average boneloss—not the range of bone loss ob-served in the study. If 1 implant of 10loses 5 mm of bone, the average boneloss in the study is 0.5 mm; yet, therange of bone loss was 0 to 5 mm.Each implant should be monitored asan independent unit when assessingbone loss for a clinical evaluation ofsuccess, survival, or failure.

Clinical observations obtained byprobing or radiographic measurementsof 0.1 mm for bone loss are operatorsensitive and are not reliable. There-fore, the Pisa Consensus in this reportsuggests that the clinical assessmentfor each implant monitors marginalbone loss in increments of 1.0 mm.The bone loss measurement should berelated to the original marginal bonelevel at implant insertion, rather thanto a previous measurement (e.g., 1year prior).

The most common method to as-sess the marginal bone loss is with aconventional periapical radiograph.Although this only determines the mesialand distal bone loss, it is a time-testedmethod. Computer-assisted imageanalysis and customized x-ray posi-tioning devices may be superior meth-ods of measuring bone loss,17 but arenot required for the criteria establishedat this consensus.

Probing Depths

Probing depths around teeth arean excellent proven means to assessthe past and present health of naturalteeth, but probing depths around im-plants may be of little diagnosticvalue, unless accompanied by signs(e.g., radiographic radiolucencies, purulent

6 IMPLANT SUCCESS, SURVIVAL, AND FAILURE

exudate, bleeding) and/or symptoms(e.g., discomfort, pain). The benefit ofprobing the implant sulcus has beenchallenged in the literature becausesound scientific criteria are lacking.Increasing probing depths over timemay indicate bone loss, but not neces-sarily indicate disease for an endostealimplant. Stable, rigid, fixated implantshave been reported with pocket depthsranging from 2 to 6 mm. Lekholm etal20 found that the presence of deeppockets was not accompanied by ac-celerated marginal bone loss. Healthy,partially edentulous implant patientsconsistently exhibit greater probingdepths around implants than aroundteeth.

Probing pressures are subjective,as is the angulation of the probe nextto an implant crown. The “correctpressure” for probing has not been de-fined for implants, but may be lessimportant than with teeth, becausethere is no connective tissue attach-ment zone next to an implant. Thepotential for damage to the fragile at-tachment or marring of the implantsurface may exist during probing.3 Onthe other hand, there is no clinical orexperimental evidence supporting thishypothesis.21 Future research in thearea of probing is needed before in-cluding this as a primary criteria in aconsensus for success, survival, and/orfailure.

On the other hand, charting theattachment level in implant permucosalareas does aid the dentist in monitor-ing these regions. Probing to monitorimplants has been suggested in severalimplant workshops and position arti-cles.22–25 Sulcus depths greater than 5to 6 mm around implants have agreater incidence of anaerobic bacte-ria26–28 and may require intervention inthe presence of inflammation or exu-date (e.g., surgery, antibiotic regi-mens). Probing not only measurespocket depth, but also reveals tissueconsistency, bleeding, and the pres-ence of exudate.29

It is of benefit to probe and estab-lish a baseline measurement after theinitial soft tissue healing around thepermucosal aspect of the implant. In-creases in this baseline measurementover time most often represents mar-ginal bone loss. In the presence ofother signs and/or symptoms, the

probing depth compared with thebaseline measurement may be diag-nostic in a clinical evaluation.

Although routine probing healthyimplants on a regular basis seems un-warranted, a baseline measurementand probing in the presence of othersymptoms and/or signs is indicated.As such, in the ICOI Pisa ConsensusCriteria, probing depths are not as-sessed in the success or satisfactoryhealth conditions, but are included inthe compromised survival condition.

Peri-implant Disease

The term peri-implantitis de-scribes the bone loss from bacteriaaround an implant.30 Peri-implantitis isdefined as an inflammatory processaffecting the tissue around an implantin function that has resulted in loss ofsupporting bone.28 Bacteria, on occa-sion, may be the primary factor forbone loss around an implant. Anaero-bic bacteria have been observed in thesulcus of implants, especially whenprobing depths are greater than 5mm.27

Stress-induced bone loss (e.g.,overloading the bone implant inter-face) occurs without bacteria as theprimary causative agent.31–34 However,once the bone loss from stress or bac-teria deepens the sulcular crevice anddecreases the oxygen tension, anaero-bic bacteria may become the primarypromoters of the continued bone loss.In other words, the bacteria involvedin peri-implatitis may oftentimes besecondary to one of the prime caus-ative factors, such as overloading thebone–implant interface.

Exudate or an abscess around animplant indicates exacerbation of theperi-implant disease and possible ac-celerated bone loss. An exudate per-sisting for more than 1 to 2 weeksusually warrants surgical revision ofthe peri-implant area to eliminatecausative elements. The reduced boneheight, after the exudate episode,makes the implant more prone to sec-ondary occlusal trauma. Therefore, thedentist must reevaluate stress factorsfor the new bony condition and oftenmust reduce them to improve long-term performance.

The ICOI Pisa Implant Quality ofHealth Scale

The ICOI Pisa Implant Quality ofHealth is based on clinical evaluation.This scale allows the dentist to evalu-ate an implant using the listed criteria,place it in the appropriate category ofhealth or disease, and then treat theimplant accordingly. Three primarycategories were established by theConsensus: success, survival, and fail-ure. The success category describesoptimum conditions, the survival cat-egory describes implants still in func-tion but not with ideal conditions, andthe failure of an implant represents animplant that should be or already hasbeen removed. There are 4 implantgroups to describe the clinical condi-tions of success, survival, or failure(Table 1).

Group I represents success and isconsidered optimum health conditions.No pain is observed with palpation,percussion, or function. No clinicalimplant mobility is noted in any direc-tion with loads less than 500 g. Lessthan 2.0 mm of radiographically cr-estal bone loss is observed comparedwith the implant insertion surgery.The implant has no history of exudate.The prognosis of Group I implants isvery good to excellent.

Group II implants are categorizedas “survival” and have satisfactoryhealth. They are stable, but show ahistory of, or potential for, clinicalproblems. No pain or tenderness isobserved on palpation, percussion, orfunction. No observable mobility ex-ists with loads less than 500 g. Radio-graphic crestal bone loss is between2.0 and 4.0 mm from the implant in-sertion. The prognosis is good to verygood, depending on the stable condi-tion of the crestal bone.

Group III implants are also in the“survival” category, but exhibit aslight to moderate peri-implantitis andcompromised health status. Group IIIimplants are characterized by no painin function. No vertical or initial hor-izontal mobility is evident. Greaterthan 4 mm radiographic crestal boneloss has occurred since implant place-ment, but bone loss is less than 50%from around the implant. Probingdepths have increased from baselineup to one-half the length of the im-


plant, often accompanied with bleed-ing on probing. Exudate episodes (ifpresent) may have lasted more than 2weeks. The prognosis is good toguarded, depending on the ability toreduce and control stress once the sur-gical corrections have improved thesoft and hard tissue health.

The Group IV of the Pisa ImplantHealth Scale is clinical or absolutefailure. The implant should be re-moved under any of these conditions:(1) pain on palpation, percussion orfunction, (2) horizontal and/or verticalmobility, (3) uncontrolled progressivebone loss, (4) uncontrolled exudate, or(5) more than 50% bone loss aroundthe implant. Implants surgicallyplaced but unable to be restored(sleepers) are also included in GroupIV failure. Regardless of whether theimplant is still in the mouth or re-moved, the implant is recorded in thiscategory as a failure in all statisticaldata. Implants that have exfoliated orhave been surgically removed are alsoin this failure category.

SUMMARY

Implant success is as difficult todescribe as the success criteria re-quired for a tooth. A range from healthto disease exists in both conditions.The primary criteria for assessing im-plant, quality, or health are pain andmobility. The presence of either onegreatly compromises the implant andremoval usually is indicated. Routineprobing depths are not suggested inthe absence of other sings or symp-toms and may be related to the pres-ence of local disease or preexistingtissue thickness before the implantwas inserted. Bone loss is most oftenevaluated with radiographs, whichonly monitor the mesial and distalmarginal bone next to the implant.

Implant failure is easier to de-scribe than implant success or survivaland may consist of a variety of factors.Any pain, vertical mobility, and un-controlled progressive bone loss war-rant implant removal.

The ICOI Pisa Consensus Confer-ence has simplified and updated a

Health Scale specific for endosteal im-plants and included categories of suc-cess, survival, and failure. In addition,these categories of health may be re-lated to the prognosis of the existingconditions.

REFERENCES

1. Schnitman PA, Shulman LB. Rec-ommendations of the consensus develop-ment conference on dental implants. J AmDent Assoc. 1979;98:373-377.

2. Cranin AN, Silverbrand H, Sher J, etal. The requirements and clinical perfor-mance of dental implants. In: Smith DC,Williams DF, eds. Biocompatibility of Den-tal Materials. Vol. 4. Boca Raton, FL: CRCPress; 1982:92-102.

3. McKinney RV, Koth DC, Steflik DE.Clinical standards for dental implants. In:Clark JW, ed. Clinical Dentistry. Harpers-town, PA: Harper & Row; 1984:27-41.

4. Albrektsson T, Zarb GA, Worthing-ton P, et al. The long-term efficacy of cur-rently used dental implants: A review andproposed criteria of success. Int J OralMaxillofac Implants. 1986;1:1-25.

5. Albrektsson T, Zarb GA. Determi-nants of correct clinical reporting. IntJ Prosthodont. 1998;11:517-521.

Table 1. Health Scale for Dental Implants*

Implant Quality ScaleClinical ConditionsGroup

I. Success (optimum health) a) No pain or tenderness upon functionb) 0 mobilityc) �2 mm radiographic bone loss from initial

surgeryd) No exudates history

II. Satisfactory survival a) No pain on functionb) 0 mobilityc) 2–4 mm radiographic bone lossd) No exudates history

III. Compromised survival a) May have sensitivity on functionb) No mobilityc) Radiographic bone loss �4 mm (less than

1/2 of implant body)d) Probing depth �7 mme) May have exudates history

IV. Failure (clinical or absolute failure) Any of following:a) Pain on functionb) Mobilityc) Radiographic bone loss �1/2 length of

implantd) Uncontrolled exudatee) No longer in mouth

*International Congress of Oral Implantologists, Pisa, Italy, Consensus Conference, 2007.


6. Smith DC, Zarb GA. Criteria for suc-cess of osseointegrated endosseous im-plants. J Prosthet Dent. 1989;62:567-572.

7. ten Bruggenkate C, van der KwastWA, Oosterbeek HS. Success criteria inoral implantology: A review of the literature.Int J Oral Implantol. 1990;7:45-53.

8. Misch CE. Implant success orfailure: Clinical assessment in implant den-tistry. In: Misch CE, ed. Contemporary Im-plant Dentistry. St. Louis: Mosby; 1993:33-66.

9. Misch CE. The implant quality scale:A clinical assessment of the health diseasecontinuum. Oral Health. 1998;15:15-25.

10. James RA. Periimplant consider-ations. Dent Clin North Am. 1980;24:415-420.

11. Salvi G, Lang N. Diagnostic param-eters for monitoring peri-implant condi-tions. Int J Oral Maxillofac Implants. 2004;19(suppl):116-127.

12. Adell R, Lekholm U, Rockler B, etal. A 15-year study of osseointegrated im-plants in the treatment of the edentulousjaw. Int J Oral Surg. 1981;10:387-416.

13. van Steenberghe D, Lekholm U,Bolender C, et al. Applicability of os-seointegrated oral implants in the rehabili-tation of partial edentulism: A prospectivemulticenter study on 558 fixtures. Int J OralMaxillofac Implants. 1990;5:272-281.

14. Sekine H, Komiyama Y, Hotta H, etal. Mobility characteristics and tactile sen-sitivity of osseointegrated fixture-supportingsystems. In: van Steenberghe D, ed. Tis-sue Integration in Oral Maxillofacial Recon-struction. Amsterdam: Excerpta Medica;1986.

15. Steflik DE, Koth DC, McKinney RVJr. Human clinical trials with the singlecrystal sapphire endosteal dental implant:Three year results, statistical analysis, andvalidation of an evaluation protocol. J OralImplantol. 1987;13:39-53.

16. Winkler S, Morris HF, Spray JR.Stability of implants and natural teeth asdetermined by the Periotest over 60months of function. J Oral Implantol. 2001;27:198-203.

17. Pasquali L, Rylander H, Carnes D,et al. Computer assisted densitometricanalysis in periodontal radiography. J ClinPeriodontol. 1988;15:27-37.

18. Kline R, Hoar JE, Beck GH, et al.A prospective multicenter clinical investi-gation of a bone quality-based dental im-plant system. Implant Dent. 2002;11:224-234.

19. Cox JF, Zarb GA. The longitudinalclinical efficacy of osseointegratedimplants: A 3-year report. Int J Oral Maxil-lofac Implants. 1987;2:91-100.

20. Lekholm U, Adell R, Lindhe J, et al.Marginal tissue reactions at osseointe-grated titanium fixtures. II. A cross-sectionretrospective study. Int J Oral MaxillofacSurg. 1986;15:53-61.

21. Esposito M, Hirsch JM, Lekholm U,et al. Biological factors contributing to fail-ures of osseointegrated oral implants. II.Etiopathogenesis. Eur J Oral Sci. 1998;106:721-764.

22. Lang NP, Karring J, Lindhe J. Pro-ceedings of the 3rd European Workshopon Periodontology (Implant Dentistry);Quintessence, 1999;220-221.

23. Proceedings of the 3rd ITI Consen-sus Conference. J Oral Maxillofac Im-plants. 2004;9(suppl):118-120.

24. American Academy of Periodontol-ogy—Position Paper. J Periodontol 2003;74:1395-1401.

25. Proceedings of the 1st EuropeanWorkshop on Evidence-based Recon-struction Dentistry. Clin Oral Implants Res.2007;18:51, 51.

26. Mombelli A, van Oosten MA,Schurch E, et al. The microbiota associ-

ated with successful or failing osseointe-grated titanium implants. Oral MicrobiolImmunol. 1987;2:145-151.

27. Rams TE, Roberts TW, Tatum H Jr,et al. The subgingival microflora associatedwith human dental implants. J ProsthetDent. 1984;5:529-534.

28. Becker W, Becker BE, NewmanMG, et al. Clinical microbiologic findingsthat may contribute to dental implant fail-ure. Int J Oral Maxillofac Implants. 1990;5:31-38.

29. Rams TE, Slots J. Comparison oftwo pressure sensitive periodontal probesand a manual periodontal probe in shallowand deep pockets. Int J Periodontics Re-storative Dent. 1993;13:521-529.

30. Mombelli A, Lang NP. The diagno-sis and treatment of peri-implantitis. Peri-odontol 2000. 1998;17:63-76.

31. Misch CE. Early crestal bone lossetiology and its effect on treatment plan-ning for implants. Postgrad Dent. 1995;2:3-17.

32. Oh TJ, Yoon J, Misch CE, et al. Thecauses of early implant bone loss: Myth orscience? J Periodontol. 2002;73:322-333.

33. Misch CE, Suzuki JB, Misch-Dietsh FM, et al. A positive correlation be-tween occlusal trauma and peri-implantbone loss: Literature support. ImplantDent. 2005;14:108-116.

34. Quirynen M, Naert I, van SteenbergheD. Fixture design and overload influencemarginal bone loss and fixture success inthe Brånemark system. Clin Oral ImplantsRes. 1992;3:104-111.

Reprint requests and correspondence to:Carl E. Misch, DDS, MDS16231 Fourteen Mile RoadBirmingham, MI 48025E-mail: [email protected]


Table Translations

GERMAN / DEUTSCH

Tabelle 1. Gesundheitstechnische Einteilung fur Zahnimplantate

Qualitätsstaffelung fur Implantate*Klinische BedingungenGruppe

I Erfolg (OptimalerGesundheitszustand)

a) Keine Schmerzen oder Empfindlichkeiten bei Aufnahme derFunktionalität

b) 0 Mobilitätc) � 2 mm radiographisch festgestellter Knochengewebsverlust

nach orster Operationd) Keine Exsudathistorie

II Zufrieden stellendeUberlebensrate

a) Keine Schmerzen bei Funktionsaufnahmeb) 0 Mobilitätc) 2 – 4 mm radiographisch festgestellter Knochengewebsverlustd) Keine Exsudathistorie

III Beeinträchtige Uberlebensrate a) Eventuell auftretende Sensitivitäten bei Funktionsaufnahmeb) Keine Mobilitätc) Radiographisch festgestellter Knochengewebsverlust �4 mm

(weniger als die Hälfte des Implantatkorperumfangs)d) Sondierungstiefe �7 mme) Eventuell vorliegende Exsudathistorie

IV Versagensfälle (Klinisches oderabsolutes Versagen)

Einer der nachfolgenden Grunde:a) Auftreten von Schmerzen bei Funktionsubernahmeb) Mobilitätc) Radiographisch festgestellter Knochengewebsverlust �1/2 der

Länge des Implantatsd) Unkontrolliertes Exsudate) Nicht mehr im Mundraum vorhanden

* Internationaler Kongress der Oralimplantologen, Pisa, Italien, Ubereinstimmungsbildende Konferenz, 2007.


SPANISH / ESPAÑOL

PORTUGUESE / PORTUGUÊS

Tabla 1. Escala de salud para implantes dentales

Escala de calidad de los implantes*Situación clínicaGrupo

I Exitoso (óptimo estado de salud) a) Sin dolor ni sensibilidad después de funcionarb) 0 movilidadc) pérdida ósea de �2 mm a partir de la cirugía iniciald) Sin antecedentes de exudados

II Supervivencia satisfactoria a) Sin dolor después de funcionarb) 0 movilidadc) pérdida ósea de 2 a 4 mmd) Sin antecedentes de exudados

III Supervivencia comprometida a) Posible sensibilidad después de funcionarb) Sin movilidadc) Pérdida ósea de � 4mm (menos de la mitad del cuerpo del implante)d) Profundidad de � 7 mme) Posibles antecedentes de exudados

IV Fracasó (Fracaso clínico o absoluto) Cualquiera de los siguientes:a) Dolor después de funcionarb) Movilidadc) Pérdida ósea de � 1/2 del largo del implanted) Exudado sin controle) Ya no se encuentra en la boca

* Congreso Internacional de Implantólogos Orales, Pisa, Italia, Conferencia de Consenso 2007.

Tabela 1. Escala de Saúde para Implantes Dentários

Escala de Qualidade de Implante*Condiçñes ClínicasGrupo

I Sucesso (Saúde ótima) a) Sem dor ou maciez durante atividadeb) 0 mobilidadec) �2 mm perda de osso radiográfico a partir da cirurgia iniciald) Sem história de exsudatos

II Sobrevivência Satisfatória a) Sem dor durante atividadeb) 0 mobilidadec) 2 – 4 mm perda de osso radiográficod) Sem história de exsudatos

III Sobrevivência Comprometida a) Pode ter sensibilidade durante atividadeb) Sem mobilidadec) Perda de osso radiográfico �4 mm (menos que 1/2 de corpo de implante)d) Profundidade da sondagem �7 mme) Pode ter história de exsudatos

IV Falha (Falha clínica ou absoluta) Qualquer dos seguintes: Dor durante atividadeb) Mobilidadec) Perda de osso radiográfico �1/2 extensào do implanted) Exsudatos nào-controladose) Nào mais na boca

* Congresso Internacional de Implantologistas Orais, Pisa, Itália, Conferência de Consenso, 2007.


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Tablo 1. Dental Implantlar için Saglık Olçegı

Implant Kalite Ölçegı*Klinik KosullarGrup

I Basarı (Optimum saglık) a) Fonksiyonda agrı veya acı yokb) 0 hareketlilik (mobilite)c) ilk cerrahiden beri radyografik kemik kaybı: �2mmd) Eksuda oykusu¨ yok

II Tatmin Edici Sagkalım a) Fonksiyonda agrı yokb) 0 hareketlilikc) 2 - 4 mm’lik radyografik kemik kaybıd) Eksuda oykusu¨ yok

III Sagkalımda Bozukluk a) Fonksiyon sırasında hassasiyet olabilirb) Hareketlilik yokc) Radyografik kemik kaybı �4 mm (implant

govdesinin 1/2’inden daha az)d) Prob derinligı �7 mme) Eksuda oykusu¨ olabilir

IV Basarısız (Klinik veya Kesin basarısızlık) Asagıdakilerin herhangi biri:a) Fonksiyon sırasında agrıb) Hareketlilikc) Radyografik kemik kaybı: implant uzunlugunun

�1/2’inden fazlad) Kontrol edilemeyen eksudae) Agızda yerlesık degıl

* Oral Implantolojistlerin Uluslararası Kongresi, Pisa, Italya, Ortak Gorus¸ Konferansı, 2007.


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implant success, survival, and failure: the international ... · §§faculty, department of oral...

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