Page 203 - Peri-implant health: the effect of implant design and surgical procedure on bone and soft tissue stability

be carried out by a team of dental care professionals including oral hygienists, general dentists, prosthodontists and periodontists. It is important to work with clear guidelines accepted by all dental care professionals and emphasize effective communication between each of these professionals.
■ SOCIALRELEVANCE
Implant dentistry is becoming more challenging in its complexity. Firstly, patients become more demanding, not only with high expectations in terms of functionality, but also in terms of aesthetics and costs. Secondly due to the increase of implant manufactures, all with different implant designs, claiming to be the best. In daily practice the dental surgeon needs to deal with the constant pressure of new products on the market. They must choose from all these implant manufacturers based on their own preferences, costs, the service of the company, and scientific evidence. Most of the time, sound scientific evidence of new design features is missing when the product is launched on the commercial market. This makes it questionable if the changes are beneficial for the patient, if they fulfil the patient’s higher expectations and if these changes are made out of commercial interest. On the other hand, some design improvements in the past led to better implant survival and an improvement in crestal bone stability.
This thesis tried to give a critical reflection, out of an evidence perspective, on implant design. The outcome is that not implant design but biological factors take precedence in the successful outcome of implant therapy. Hopefully, this thesis could make implant treatment less complex for the dental surgeons by showing that not the choice of implant manufacturer or design defines the success of implant surgery, but rather proper education and understanding of the reactions of oral tissues on implant surgery.
In addition, this thesis tried to clarify the problems that exist when the field lacks an internationally accepted definition for peri-implantitis. Nowadays, it is still difficult to give a clear answer to the patient about how big the risk of peri-implantitis is. Moreover, it could harm the good reputation of implant treatment if scientific papers with high percentages of peri-implantitis based on poor definitions are used in the media.
GENERAL DISCUSSION
201
8