UCSF

Objective: This short-term prospective pilot study aimed to assess the validation of the patient-centered implant risk assessment tool in patients recruited at the University of California, San Francisco (UCSF) School of Dentistry.Materials and Methods: Patients seen in the university periodontal clinics were enrolled in the study based on their eligibility for dental implant treatment. For each implant placed, dental surgeons completed a survey tool, called the Implant Risk Assessment Questionnaire (RAQ). After at least one year of loading with the implant final prosthesis, patients were seen for a recall visit at which point, the implant was diagnosed as healthy or having peri-implant disease. The peri-implant disease was subcategorized as peri-implant mucositis and peri-implantitis. The survey output classifies the implant as low, medium, or high aggregate risk, which was correlated to diagnoses of healthy, peri-implant mucositis, or peri-implantitis respectively. The RAQ scores and diagnoses were used to compute sensitivity, specificity, and positive and negative predictive values to determine the tool's validity. Results: In total, seventy-three patients with 187 implants were initially recruited for the study. However, only thirty-three patients, representing eighty-seven implants, participated in the one-year follow-up and were consequently included in the study results. Among these implants, fifty-four were diagnosed as healthy, ten as peri-implant mucositis, and six as peri-implantitis. Additionally, four implants experienced early failures before the delivery of the prosthesis. Initially, the sensitivity, specificity, and positive and negative predictive values of the RAQ tool were low, indicating a limited predictive value within this timeframe. However, these parameters were notably improved by omitting questions that were found to diminish the predictive ability of the test. Specifically, questions related to treated periodontitis, smoking, tissue phenotype, maxillary posterior placement, clinician experience, and restoration emergence angle were removed to improve the validity parameters for this short-term study. Following the omission of these questions, there was a significant increase in sensitivity from 22.22% to 74.07%, while specificity decreased from 100.0% to 62.5%. The positive predictive value also experienced a shift from 100.0% to 86.96%, whereas the negative predictive value showed improvement from 27.59% to 41.67%. When comparing the results before and after the exclusion of these questions predictive value also increased from 0% to 62.5%. Conclusion: In a short-term context, the RAQ survey tool might have limited utility in its original form to identify cases of health and disease, but if modified to omit certain risk categories, its predictive capacity could be increased. A long-term follow-up study is necessary to evaluate the validity of the original RAQ survey tool across different risk categories.