Consensus

Systematic Review of Clinical and Patient-Reported Outcomes Following Oral Rehabilitation on Dental Implants with a Tapered Compared to a Non-Tapered Implant Design

Amsterdam 2018

Preamble

Approximately 50% of all implants on the market are tapered. In this systematic review, a tapered implant is recognized as a cylindrical implant where the endosseous part narrows in diameter toward the apex. The rationale for using this implant design is to improve primary stability and subsequent treatment success.

The present systematic review evaluated the scientific evidence related to implant survival and success to address the question: In patients with dental implant restorations, do tapered compared to non-tapered implants demonstrate similar clinical and patient-reported outcomes?

Twentynine articles were identified of which three RCTs reported outcomes at 3 years. The three RCTs described the results of 245 patients with 388 implants at three years and reported clinically insignificant differences. The three RCTs each reported different clinical outcomes and the data were not comparable. None reported patient-reported outcomes or maintenance needs. All three RCTs have a moderate risk of bias. Meta-analyses were not conducted.

Consensus Statements

  • The evidence shows that both tapered and non-tapered implants demonstrate satisfactory performance with respect to marginal bone levels at 3 years. This statement is based on the evidence of three RCTs, (245 patients with 388 implants).
  • There is currently insufficient evidence to conclude if tapered compared with non-tapered implants demonstrate similar clinical and patient-reported outcomes. This statement is based on the evidence from three RCTs, (245 patients with 388 implants).

Clinical Recommendations

  • Is there a recommendation for any specific implant design with regard to taper? Based on Consensus statements 1 and 2, both tapered and non-tapered implants can be used according to the operator’s preference.
  • Are there particular clinical situations in which any specific implant design with regard to taper is preferred? Tapered implants can be considered in clinical situations to avoid injuring anatomical structures or causing apical fenestrations. Appropriate professional judgment and clinical decision-making must include a comprehensive diagnosis of the patient’s jawbone anatomy, bone quality and quantity, and osteotomy protocol.
  • Is utilizing a tapered implant an effective strategy to increase insertion torque? In situations where increased insertion torque is desired, tapered implants may be considered. The shape of the dental implant is only one contributing factor to achieve high insertion torque; however, the clinical significance of implant shape on long-term results is unclear.

References

Publication date: Nov 16, 2018 Last review date: Nov 9, 2018 Next review date: Nov 9, 2021
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