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2.3 Is the Clinician a Risk Factor?

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With the increasing popularity of dental implant treatments with both patients and dental practitioners, the risks associated with the clinician are often overlooked. Derks and coworkers (Derks et al, 2016) described a situation where implant complications from peri-implantitis were significantly correlated with the level of experience of the dentist who was completing the restorative part of the treatment. In this study of real-world treatments, general dentists were 4.3 times more likely to be associated with a peri-implantitis problem than were restorative specialists. While this result may relate to confounding biases in the data set used in this study, which could not be controlled due to the nature of the data, it is still a somewhat disconcerting statistic.

It is also a concern in connection with the incidence of complaints and medicolegal claims relating to implant treatments that are increasing in many jurisdictions. In some regions, professional indemnity insurers are charging additional premiums for particular groups of practitioners who are participating in implant dentistry. These insurance companies do so on the basis of their own actuarial research, which indicates additional risk associated with these treatments in the hands of specific cohorts of practitioners.

The SAC Classification in Implant Dentistry

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