# The National Dental Practice-Based Research Network Dental Implant Restoration Registry to Evaluate Dental Implant Outcomes in Community Practice Settings: Protocol for a Prospective Observational Study

## TL;DR

This study tracks dental implant outcomes in community practices to understand complications and improve patient care.

## Contribution

Establishes a national registry to evaluate implant complications in real-world community dental settings.

## Key findings

- 1453 patients and 2087 implant restorations were enrolled across 6 regional nodes.
- Baseline data collection was completed for 81.1% of patient surveys and 100% of clinical forms.
- The registry will provide real-world evidence to improve clinical decision-making and patient outcomes.

## Abstract

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.

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

This prospective observational cohort study plans to include approximately 2000 implant restorations from 1550 patients receiving implant restorations from 150 practitioners across 6 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. Digitized radiographs will be centrally reviewed for peri-implant bone changes, emergence angle, and prosthetic fit. The primary outcome is the 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.

Of 430 practitioners who expressed initial interest, 187 (43.5%) completed training and began patient enrollment, with 143 (76.5%) of these practitioners enrolling at least one participant. A total of 1453 patients were registered between August 2022 and October 2024. Practitioner activity and enrollment peaked in late 2023. Overall, 1178 (81.1%) baseline patient surveys and 1453 (100%) baseline clinical forms were completed, covering 2087 dental implant restorations.

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.