JMIR Publications

ABSTRACT

Background:

Dental implants are a widely used therapeutic option for tooth replacement; however, biological and prosthetic complications may compromise implant success. While prior research has largely focused on academic or specialty settings, data on implant outcomes in community dental practices remain limited.

Objective:

This study aims to establish a national registry within the National Dental Practice-Based Research Network (PBRN) to evaluate the incidence and factors associated with biological and prosthetic complications following implant therapy in community practice settings.

Methods:

This prospective, observational cohort study plans to enroll approximately 2,000 implant restorations from 1,550 patients receiving implant restorations from 150 practitioners across six regional Network nodes. Clinical, implant, and prosthetic characteristics will be recorded at baseline, with annual follow-up visits collecting data on complications, implant failures, prosthetic issues, and patient-reported outcomes. Digitalized radiographs will be centrally reviewed for peri-implant bone changes, emergence angle, and prosthetic fit. The primary outcome is incidence of biological and prosthetic complications. Secondary analyses will evaluate patient-centered outcomes and identify risk factors for complications. Multilevel mixed-effects regression and time-to-event analyses will be used to account for clustering and censored data.

Results:

Of 430 practitioners who expressed initial interest, 187 completed training and began patient enrollment, with 144 enrolling at least one participant. A total of 1,471 patients were registered between August 2022 and October 2024. Practitioner activity and enrollment peaked in late 2023. Overall, 81% of baseline patient surveys and 99% of baseline clinical forms were completed covering 2,103 dental implant restorations from 1,463 participants.

Conclusions:

The registry will generate robust, real-world evidence on implant-related complications and their predictors in community practice. The findings will enhance clinical decision-making, support personalized risk assessment, and ultimately improve patient outcomes in implant dentistry.