Referral patterns of general dental practitioners for bone grafting and implant placement

Background: Dental implant rehabilitation is a well-established procedure often conducted in the general dental practise setting. The outcomes for implant placement are reliable when the recipient site is favourable. The goal of this study was to assess the accuracy with which general dental practitioners (GDP) assess the bone volume available for implant placement and their referral patterns for implant sites, which may require bone grafting. Methods: Fifty-three GDP were surveyed and asked to assess five different scenarios and cone-beam scans for difficulty (0, ‘no difficulty’; 5, ‘the most difficult’), and bone grafting requirements (‘yes’/‘no’ and ‘who to perform’), prior to implant placement. Results: The GDP assessment of difficulty for the cases was: no graft required, 1.88; aesthetic zone involvement, 3.25; vertical deficiency, 2.8; sinus lift required, 3.68; and horizontal deficiency, 4.4. GDP seemed to have some difficulty identifying which cases required a bone graft, occasionally grafting a site with sufficient bone (12.5%), or not grafting a site with insufficient bone (45–75%). Conclusions: These results show that GDP are accurate in assessing the difficulty of an implant case and conservative when it comes to attempting these complex cases. GDP are less confident when it comes to recognizing cases that require bone grafting, and what options are available.