ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Patient Satisfaction Levels are Generally High with Guided Flapless Implant Placement Surgery
Clinical Question In patients who receive dental implant therapy, how do postoperative satisfaction levels vary for guided flapless implant placement vs. conventional flap surgery?
Clinical Bottom Line In patients who experienced both computer-guided and conventional treatments, they revealed that they felt less pain and higher satisfaction (93.8%) with computer-guided surgery. Patients who were either 50 years of age or older, had higher education levels, and higher salaries were statistically more satisfied with their implant procedure compared to others in regards to VAS. For those who learned about the computer-guided surgery template, a majority learned from their dentist (43.2%), 29.7% internet research, 24.3% mass media, and 2.7% by recommendations from friends. Top reasons for choosing guided implant surgery: "accurate and safe": 43.2% strongly agree and 45.9% agree.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 25352962Young-Youk/2014N=135 patients who had undergone dental implant surgeryRandomized Controlled Trial
Key resultsThis was a retrospective analysis of 135 people who had undergone implant surgery in hospitals or dental clinics in Seoul, South Korea and were asked to complete a survey (25 questions). 27.4% had guided surgery and 66.7% had conventional implant surgery. 97.2% of patients ‘agreed’ or ‘strongly agreed’ to feeling less discomfort and more relaxed during implant surgery using the computer-guided template. 94.5% of patients ‘agreed’ or ‘strongly agreed’ when asked if they were feeling satisfied with computer-guided surgery. Results revealed that patients in their 50s or older felt higher satisfaction with implant surgery than those in their 20s-40s. Patients with higher education levels tend to have higher satisfaction than those who had lower levels of education. Patients who have higher income also have higher satisfaction with their implants compared to those with a smaller income, where all results were P<.05.
#2) 24977244Pommer/20141328 patients in 37 included studiesSystematic review of randomized trials
Key resultsA review of the Literature evaluating various “non-invasive” techniques where flapless implant placement was one clinical treatment evaluated. Overall, Patient satisfaction averaged 91% with flapless implant placement and ranged from 77 to 100. 77% of patients in one study chose “flapless surgery” to “avoid open {flaps}” In a study looking at patients receiving 4-6 implants in the edentulous maxilla. In patients that had flap surgery they were significantly (p <.01) less likely to repeat the surgical procedure and recommend the procedure to a friend.
Evidence Search “patient satisfaction guided implant surgery”, “dental implants patient satisfaction”
Comments on
The Evidence
Validity: Overall, the validity of the findings is limited to the patient populations studied. The level of available evidence is variable and needs to be investigated further. In Youk/2014, there “was a limitation in the comparative analysis due to the substantially small ratio of research subjects compared to that of patients who have undergone conventional implant surgery without the computer-guided template.” In Pommer/2014, the authors conceded there was a challenge in trying to compare literature results due to the diverse outcome assessments conducted by various researchers. Perspective: There is limited high-quality evidence to address this theme because of a lack of truly randomized controlled studies and the inability to standardize and quantify patient satisfaction levels, which are subjective experiences.
Applicability Many articles have looked at accuracy and clinical results comparing guided surgery to traditional flapless techniques with varying results. However, even the most accurate of procedures will not thrive in clinical practice if patient acceptance/perception of value is not high. The purpose of this question is to aid practitioners when speaking to their patients with regard to expected experiences and outcomes of guided surgery.
Specialty/Discipline (General Dentistry) (Oral Surgery) (Periodontics) (Prosthodontics) (Restorative Dentistry)
Keywords patient satisfaction, guided surgery, flapless surgery
ID# 2853
Date of submission: 04/04/2015spacer
E-mail cabreram@livemail.uthscsa.edu
Author Marinee Cabrera
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Ryan Sheridan, DDS
Faculty mentor/Co-author e-mail sheridanr@uthscsa.edu
Basic Science Rationale
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Comments on the CAT
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