Dental implants are increasingly widely available and is producing predictable outcomes for patients. Patients receiving dental implants are often enthusiastic about this type of treatment regardless of the extent of their tooth loss. Improving the patients’ experience of dental implants may improve satisfaction. This review aims to report and summarise the findings of published qualitative studies relating to patients’ experience of implant treatment at various stages of their treatment pathway.

Methods

Searches were conducted in the PubMed, Embase, Scopus, Web of Knowledge, Cochrane Database and Google Scholar databases. Original articles reporting patients’ experience with dental implant were considered. Only English language papers were considered. Initial inclusion criteria and categories for analysis were discussed and agreed by all reviewers. Data abstraction was initially undertaken by a single reviewer and reviewed by other authors. Emerging analysis was led by a single reviewer and refined in discussion with other reviewers.

Results

• 10 studies were included.
• 4 were carried out in the UK, 1 between the UK and Canada, 4 in Sweden, 1 in New Zealand. 8 studies used 1-1 interviews; 1 a focus group; 1 telephone interview.
• Methods of data analysis were not always clearly described but thematic analysis and constant comparative methods of grounded theory were the preferred approaches used.
• All 10 studies included patients who had experienced tooth loss and conventional complete dentures replacement before they sought implant treatment.

Conclusions

The authors concluded:

This textual narrative synthesis of qualitative studies provided insight into current patients’ perceptions of different aspects of implant treatment and highlighted directions for further investigation and reports.

In general, there were two main factors motivating patients to elect for implant replacement, to improve confidence and existing functional problems with other types of conventional restoration. The included qualitative studies provided insight into patients’ experiences of two types of implant prostheses namely implant supported overdentures (ISOD) and fixed implant supported prostheses (FISP). Findings across reviewed papers suggested that while patients experienced functional and social improvements after both types of restoration, they additionally saw treatment with FISP as a process of ‘normalisation’ and believed that such implant restorations could be similar to natural teeth. Across studies, less consideration was given to young patients; patients with single and limited tooth loss; and to patients’ expectations of dental implants and the significance of this for treatment decision making and future satisfaction. Future work might focus on investigating patients’ experiences and understanding of dental implants at stages I and II, and on how this influences patients’ expectation of, and satisfaction with, the implant restoration.

Comments

This review adopted a textual narrative synthesis, which aims to organise studies relating to the same topics into more consistent categories of findings and facilitate recognition of similarities and disparities. Study quality was assessed by the reviewers but they note that the criteria used did not distinguish a high vs. low quality studies although they did highlight a number of limitations e.g. studies’ samples were not clearly described in terms of the extent of patients’ tooth loss and failure to describe other elements of the study which may have been due to journal word limits. The narrative findings were considered in 4 sections; pre-implant treatment; decision-making process of dental implant treatment; experience with implant treatment and experience with implant restorations. With the last section being divided into; patients’ experience after the replacement with FISP and patients’ experience after the replacement with ISOD.

Links

Kashbour WA, Rousseau NS, Ellis JS, Thomason JM. Patients’ experiences of dental implant treatment: A literature review of key qualitative studies. J Dent. 2015 Apr 25. pii: S0300-5712(15)00102-5. doi: 10.1016/j.jdent.2015.04.008. [Epub ahead of print] Review. PubMed PMID: 25921332