Current treatment concepts in implantology in oral and maxillofacial surgery in Germany.

Abstract

Introduction: Dental implantology is a core competency of Oral and Maxillofacial Surgery (OMFS). However, detailed data on the current treatment concepts in implantology in OMFS in Germany are limited. This study analyzed current treatment concepts, clinical practices, decision-making factors, and the adoption of advanced technologies in implantology in OMFS in Germany.

Material and methods: A dynamic online questionnaire with up to 38 questions was sent to 1391 OMFS members of the German Association of Oral and Maxillofacial Surgery (DGMKG). The questionnaire collected general and specific data, such as implantological experience, time points of implant placement (immediate vs. delayed), implant systems and designs, imaging modalities, digital planning, guided surgery, healing, (immediate) prosthetic restorations, follow-up, pre- and postoperative management, and the use of platelet-rich fibrin (PRF). Data analysis was descriptive and anonymous.

Results: 276 OMF surgeons participated in the study, with an average of 20 years of experience in implantology. Most worked in private practices without inpatient facilities (66.3%). Most placed 201-500 implants per year (34.78%). 78.99% performed immediate implant placement, mainly to shorten treatment time and preserve alveolar bone. Cone beam CT (88.42%) and panoramic radiographs (68.34%) were the most common imaging modalities. Virtual planning was used by 73.08%, and guided surgery was used by 66.54%, mainly with externally produced guides. Most participants preferred closed implant healing (83.53%). Immediate prosthetic restorations (PR) were rarely performed (57.83% never), and 70.92% did not carry out definitive PR. Risk factors for implant failure were poor oral hygiene (84.72%), limited surgical experience (76.39%), and smoking (75%). PRF was used routinely by 9.72%, and selectively by 45.83% CONCLUSION: The results indicate high implantological standards and heterogeneity in current treatment concepts in OMFS implantology in Germany. Possible reasons may include the surgeon's training and experience, the private practices' and clinics' organizational and structural features, and the referral network.

Clinical relevance: This study underscores the importance of implantological education and training, interdisciplinary communication, and the further implementation of guidelines.