The Complete Guide to Dental Implants (Domain Overview): from assessment and bone management through surgery to long-term maintenance｜證據鏈

The Complete Guide to Dental Implants (Domain Overview): from assessment and bone management through surgery to long-term maintenance｜證據鏈

12. F-Units (fact ledger)

Expand the 29 fact units (source # / confidence / basis / geo / period / caveat / verbatim span)

F1｜S3｜confidence: high｜basis: peer_reviewed｜geo: universal｜period: prospective studies with ≥20 years of follow-up included; published 2026 Meta-analysis of prospective studies with ≥20 years of follow-up: the subjects are titanium endosseous dental implants with cylindrical or conical screw-shaped designs; 20-year survival rate 93.0% (95% CI 91.6–94.1%), pooled mean marginal bone loss 1.11 mm (95% CI 0.55–1.68 mm); GRADE certainty moderate. span: "assess the 20-year survival rate and marginal bone loss (MBL) of titanium endosseous dental implants with cylindrical or conical screw-shaped designs" / "The 20-year implant survival rate was 93.0% (95% confidence interval 91.6-94.1%)" / "The pooled mean MBL was 1.11 mm (95% confidence interval 0.55-1.68 mm)" / "The certainty of the evidence (GRADE framework) was rated as moderate for both implant survival and MBL; however, this rating was limited by substantial heterogeneity" caveat: A population-level estimate with high heterogeneity; it cannot be used to estimate an individual outcome; only 10 studies were included.

F2｜S3｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: as F1 Of 115 implant failures, only 44 had their cause of failure explicitly reported, and biological and mechanical causes were almost equally distributed. span: "The specific cause of failure was explicitly reported for 44 of the 115 implants and was almost equally distributed between biological and mechanical causes." / "These reported 1857 implants (baseline) of which 1028 were followed up for ≥20 years, during which 115 implant failures were recorded." caveat: The denominator for "almost equally distributed" is only the 44 cases with an explicitly reported cause, and it must not be written up as the distribution of causes across all 115 failures or across the whole 20-year follow-up; this denominator limit must accompany any citation of the unit.

F3｜S4｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: database search to 2024-06 The umbrella review graded the association between smoking and implant failure as highly suggestive. span: "25 articles describing 35 associations were included in the study." / "Highly suggestive evidence was established for the association between smoking and implant failure." caveat: An association from observational research, not proof of causation.

F4｜S4｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: as F3 The three associations rated high certainty (GRADE) among the meta-analyses of RCTs, in every case with the former associated with a higher risk of implant failure: turned versus anodized surfaces, submerged versus nonsubmerged healing, and bone augmentation with long implants versus short implants; those graded suggestive among the observational studies include periodontally compromised patients, bone quality classification, loading protocol and implant length. span: "turned versus anodized implants, submerged versus nonsubmerged implant healing, and bone augmentation with long implants versus short implants were associated with a higher risk of implant failure (high certainty evidence)" / "Suggestive evidence emerged for associations including periodontally compromised versus periodontally healthy patients" caveat: The direction of each association follows from how the comparison groups are defined, and no single item may be pulled out on its own for an absolute judgement. The direction must not be deleted: the original states explicitly that these three "were associated with a higher risk of implant failure", and writing only "associations with high-certainty evidence" without the direction would leave the reader unable to tell which side carries the higher risk (the direction of "bone augmentation with long implants vs short implants" runs against doing more bone augmentation, and is particularly not to be omitted). This article does not cite the recommendation on the use of anodized implants in that review's conclusion section — choice of device is a clinical judgement, and this article's compliance principle is to endorse no material or device.

F5｜S4｜confidence: high｜basis: peer_reviewed｜geo: universal｜period: as F3 Among the meta-analyses of cohort and case-control studies, no association was graded convincing. span: "None were graded as convincing." caveat: Applies only to the 26 observational meta-analyses included in that review.

F6｜S2｜confidence: high｜basis: clinical_guideline｜geo: universal｜period: 2017 World Workshop (published 2018) Peri-implantitis = a plaque-associated pathological condition occurring in the tissues around implants, characterised by mucosal inflammation together with progressive loss of supporting bone; clinically there are signs of inflammation, bleeding on probing and/or suppuration, increased probing depth and/or recession of the mucosal margin, plus radiographic bone loss. span: "Peri-implantitis is a plaque-associated pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone." / "Peri-implantitis sites exhibit clinical signs of inflammation, bleeding on probing, and/or suppuration, increased probing depths and/or recession of the mucosal margin in addition to radiographic bone loss." caveat: A case definition, not an individual diagnosis; diagnosis must be carried out by a clinician.

F7｜S2｜confidence: high｜basis: clinical_guideline｜geo: universal｜period: as F6 The main clinical characteristic of peri-implant mucositis is bleeding on gentle probing, possibly with erythema, swelling or suppuration; there is strong evidence from animal and human experimental studies that plaque is its etiological factor. span: "The main clinical characteristic of peri-implant mucositis is bleeding on gentle probing. Erythema, swelling, and/or suppuration may also be present." / "There is strong evidence from animal and human experimental studies that plaque is the etiological factor for peri-implant mucositis." caveat: As F6.

F8｜S2｜confidence: high｜basis: clinical_guideline｜geo: universal｜period: as F6 Peri-implant health is characterised by the absence of erythema, bleeding on probing, swelling and suppuration; no range of probing depths compatible with health can be defined; peri-implant health can exist around implants with reduced bone support. span: "Peri-implant health is characterized by the absence of erythema, bleeding on probing, swelling, and suppuration. It is not possible to define a range of probing depths compatible with health; Peri-implant health can exist around implants with reduced bone support." caveat: As F6.

F9｜S2｜confidence: high｜basis: clinical_guideline｜geo: universal｜period: as F6 The consensus report recommends that the clinician obtain baseline radiographic and probing measurements following completion of the implant-supported prosthesis. span: "It is recommended that the clinician obtain baseline radiographic and probing measurements following the completion of the implant-supported prosthesis." caveat: A recommendation for clinical practice, not something for patients to carry out themselves.

F10｜S2｜confidence: medium｜basis: clinical_guideline｜geo: universal｜period: as F6 The evidence on the effect of keratinized mucosa on the long-term health of the peri-implant tissue is inconsistent; keratinized mucosa may, however, have advantages in patient comfort and ease of cleaning. span: "The evidence is equivocal regarding the effect of keratinized mucosa on the long-term health of the peri-implant tissue. It appears, however, that keratinized mucosa may have advantages regarding patient comfort and ease of plaque removal." caveat: The report states of itself that the evidence is equivocal, and it must not be written up as settled.

F11｜S16｜confidence: high｜basis: peer_reviewed｜geo: universal｜period: published 2021, 28 studies included (20 quantifiable) Unassisted healing after extraction, pooled in strata of "measurement method × tooth site": under clinical measurement, mean horizontal ridge reduction at non-molar sites 2.73 mm (95% CI 2.36–3.11) and vertical mid-facial 1.71 mm (95% CI 1.30–2.12); under radiographic measurement, mean horizontal reduction at non-molar sites 2.54 mm (95% CI 1.97–3.11) and at molar sites 3.61 mm (95% CI 3.24–3.98). span: "Pooled estimates revealed that mean horizontal, vertical mid-facial and mid-lingual ridge reduction assessed clinically in non-molar sites was 2.73 mm (95% CI: 2.36-3.11), 1.71 mm (95% CI: 1.30-2.12) and 1.44 mm (95% CI: 0.78-2.10), respectively." / "Mean horizontal, vertical mid-facial and mid-lingual ridge reduction assessed radiographically in non-molar sites was 2.54 mm (95% CI: 1.97-3.11), 1.65 mm (95% CI: 0.42-2.88) and 0.87 mm (95% CI: 0.36-1.38), respectively." / "Mean horizontal, vertical mid-facial and mid-lingual ridge reduction assessed radiographically in molar sites was 3.61 mm (95% CI: 3.24-3.98), 1.46 mm (95% CI: 0.73-2.20) and 1.20 mm (95% CI: 0.56-1.83), respectively." caveat: Clinical measurement and radiographic measurement are different methods and their numbers cannot be substituted for one another. Comparisons across tooth sites are permitted only within the same measurement method (radiographic: non-molar 2.54 vs molar 3.61); setting the clinical 2.73 against the radiographic 3.61 is a cross-method splice and does not hold.

F12｜S16｜confidence: high｜basis: peer_reviewed｜geo: universal｜period: as F11 The amount of alveolar bone resorption occurring after unassisted socket healing varies with tooth type. span: "A variable amount of alveolar bone resorption occurs after unassisted socket healing depending on tooth type." caveat: It describes only that variation exists, and gives no individual predicted value.

F13｜S6｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: published 2026, 53 studies included Bone graft materials fall into four types: autogenous, allograft, xenograft and alloplastic; there is still no consensus on which is superior, and definitive conclusions were not possible because of the lack of high-quality evidence. span: "Fifty-three studies were included." / "These procedures utilize bone grafting materials of which there are four types, namely, autogenous, allograft, xenograft, and alloplastic grafts. However, there is still no consensus on which material is superior." / "due to the lack of high-quality evidence in this review, definitive conclusions on which material is superior was not possible" caveat: The methods of the individual studies differ widely, so their results cannot be compared directly.

F14｜S6｜confidence: high｜basis: peer_reviewed｜geo: universal｜period: as F13 The natural physiological bone resorption that follows tooth loss often leaves the available bone volume insufficient to place the implant in the position the restoration requires; bone regeneration procedures such as guided bone regeneration (GBR), sinus augmentation (SA) and alveolar ridge preservation (ARP) were developed as a result. span: "The natural physiological bone resorption following tooth loss often results in reduced bone volume to place dental implants in a restoratively driven position. Bone regeneration procedures such as guided bone regeneration (GBR), sinus augmentation (SA), and alveolar ridge preservation (ARP) have therefore been developed to promote new bone formation." caveat: Whether a technique applies is a case-by-case judgement.

F15｜S5｜confidence: high｜basis: peer_reviewed｜geo: universal｜period: published 2026, 100 studies included (PROSPERO CRD420251052858) Pooled complication rates of maxillary bone augmentation techniques: sinus lift 7.98% (95% CI 2.78–15.55), guided bone regeneration 26.44% (95% CI 13.06–42.52), onlay grafting 19.61% (95% CI 13.94–25.99), mixed techniques 20.10% (95% CI 13.92–27.09); the more frequent types were membrane or graft exposure, wound dehiscence and infection. span: "Of the 2,266 articles reviewed, 100 were selected." / "Pooled complication rates were: 7.98% (95% CI: 2.78 - 15.55) for sinus lift, 26.44% (95% CI: 13.06 - 42.52) for guided bone regeneration, 19.61% (95% CI: 13.94 - 25.99) for onlay grafting, and 20.10% (95% CI: 13.92 - 27.09) for mixed techniques. The most frequent complications were membrane or graft exposure, wound dehiscence, and infection." / "The analysis focused on postoperative complications in maxillary bone regeneration techniques." caveat: Site restriction = the maxilla (the original states maxillary in two places); it must not be extrapolated to bone augmentation in the mandible. Technique restriction = the four techniques sinus lift / guided bone regeneration / onlay grafting / mixed techniques; alveolar ridge preservation (ARP) is not covered, and this unit must not be used in the same sentence as a list of techniques that includes ARP. The confidence intervals are wide and heterogeneity is large.

F16｜S7｜confidence: high｜basis: peer_reviewed｜geo: universal｜period: published 2025-12, 11 RCTs (IIP 353 patients / ARP 348 patients) Authors' conclusion: immediate implant placement (IIP) can achieve esthetic outcomes and implant success comparable to alveolar ridge preservation (ARP), but there may be a higher incidence of postoperative complications and greater marginal bone alterations. Corresponding data in the results section: no statistically significant difference was observed for the esthetic score (PES) MD −0.05 (95% CI −0.52 to 0.43) or for implant failure OR 2.09 (95% CI 0.98 to 4.44); postoperative complications were higher in the IIP group (p < 0.05). span: "Eleven RCTs were included, involving 353 patients in the IIP group and 348 patients in the ARP group." / "no statistical differences were observed regarding PES (MD = -0.05, 95% CI = -0.52 to 0.43) or implant failure (OR = 2.09, 95% CI = 0.98 to 4.44)" / "both groups achieved similar outcomes in terms of horizontal width change, facial gingival margin change, and patient-reported satisfaction (P > .05), except for a higher incidence of postoperative complications observed in the IIP group (p < 0.05)" / "the IIP protocol can achieve comparable esthetic outcomes and implant success as the ARP protocol; however, there may be a higher incidence of postoperative complications and MBL alterations." caveat: The authors state that they are constrained by the limitations of the research and that longer-term RCTs are needed for confirmation. Statistical meaning of "comparable": the conclusion sentence's comparable esthetic outcomes and implant success correspond to two items that showed "no statistically significant difference", PES and implant failure; for implant failure the point estimate OR 2.09 leans towards a higher rate with immediate placement, the upper bound of the 95% CI is close to 4.5, and only 11 trials were included (353 patients / 348 patients), so power is limited — "not statistically significant" must not be rewritten as "the two carry comparable failure risk / are equally safe" (absence of evidence ≠ evidence of absence). Hedging restriction: postoperative complications are written as "may be" in the CONCLUSION section but appear as a between-group difference at p < 0.05 in the RESULTS section; if the body text states this as a fact, it must cite the RESULTS span and mark it as that review's result, and must not remove the hedge on the basis of the CONCLUSION sentence alone.

F17｜S8｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: published 2026-06, 7 RCTs, n=589 A systematic review of preemptive use of oral steroidal or nonsteroidal anti-inflammatory drugs, with primary outcomes of postoperative pain, oedema, trismus, discomfort and use of rescue medication; because of the high heterogeneity in regimens and outcome measures, no definitive conclusion could be drawn as to which preemptive agents are most effective and safest. span: "The primary outcomes were postoperative pain, edema, trismus, discomfort, and use of rescue medication." / "Seven RCTs (n = 589 patients)" / "Owing to the heterogeneity in protocols, drug regimens, and outcome measures, definitive conclusions regarding the most effective and safest preemptive agents could not be drawn." caveat: This article deliberately does not cite the drug names and doses in that review (prescribing is a clinical act, and medication instructions are not appropriate in public health education).

F18｜S9｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: published 2026-01, 10 randomised placebo-controlled / controlled trials, approximately 1,950 participants pooled A random-effects meta-analysis covering invasive dental procedures of all kinds (including implant placement and extraction): the intervention is defined as systemic antibiotics and/or local antiseptic prophylaxis, and the pooled endpoint is early procedure-related infectious outcomes and/or bacteremia-related endpoints; antimicrobial prophylaxis showed no statistically significant overall reduction in the primary pooled endpoint (MD −0.12, 95% CI −0.31 to 0.07; I² ≈ 99%); implant trials themselves had low event rates and did not consistently demonstrate a clinically meaningful superiority of routine prophylaxis. span: "Prophylactic antimicrobials are frequently administered before invasive dental procedures (including implant placement and extractions)" / "Included studies evaluated perioperative prophylaxis (systemic antibiotics and/or local antiseptic prophylaxis) versus placebo or no prophylaxis in invasive dental procedures." / "Outcomes were harmonized across studies as early procedure-related infectious outcomes and/or bacteremia-related endpoints" / "Across all invasive dental procedures (~1,950 participants pooled), prophylaxis did not demonstrate a statistically significant overall reduction in the primary pooled endpoint (MD -0.12, 95%CI -0.31 to 0.07; random-effects; I² ≈ 99%)" / "Individual trials showed marked reductions in post-extraction bacteremia surrogates with chlorhexidine mouthwash prophylaxis" / "Implant trials reported low event rates and did not consistently demonstrate clinically meaningful superiority of routine prophylaxis." / "Funnel plot inspection suggested possible small-study effects influenced by outliers, but interpretation was constrained by extreme between-study heterogeneity." metadata as measured (2026-08-06 efetch, HTTP:200): the PublicationType PubMed registers for this paper is `['Journal Article', 'Review']` — neither Systematic Review nor Meta-Analysis is registered (for contrast: S10 / PMID 32591710 is registered as `['Journal Article', 'Meta-Analysis', 'Systematic Review']`; S5 / PMID 41077306 as `['Journal Article', 'Systematic Review', 'Meta-Analysis']`). caveat: I² ≈ 99% is extreme heterogeneity, the authors state that their interpretation is constrained by it, and the funnel plot suggests possible small-study effects. Effect-size scale restriction: the primary pooled endpoint here is pooled as a mean difference (MD −0.12), which is a different scale from S10's pooling of implant failure as a risk ratio (RR 0.47); the two figures cannot be converted into one another and cannot be compared directly for magnitude. Publication-type restriction: when placed beside S10, the difference in PublicationType above must be disclosed, and the two must not simply be called two "camps" of the same standing. When citing this unit, three restrictions must not be omitted: (a) the intervention includes local antiseptics (individual trials included chlorhexidine mouthwash), so it cannot be shortened to "oral antibiotics do not work"; (b) the endpoint includes a bacteremia surrogate, which is not the same thing as "implant failure"; (c) the endpoint pools across procedure types and is not a conclusion specific to implants. The difference from the implant-specific review (S10) arises from procedural scope / intervention definition / endpoint, not from the passage of years, and must not be written up as "new research overturns old research".

F19｜S9｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: as F18 Microbiological evidence indicates that single-dose prophylaxis can produce short-term ecological disturbance and selection of resistant oral flora. span: "microbiological evidence indicates that single-dose prophylaxis can promote short-term ecological disturbance and selection of resistant oral flora." caveat: An inference from experimental research, not a clinical outcome measure.

F20｜S10｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: published 2020-06, search to 2018-02, 14 publications Prophylactic antibiotics are associated with a reduced risk of implant failure. Intervention definition (original) = prophylactic antibiotics "prescribed prior to implant surgery, and prior to and immediately following it (PIFS)"; among the implants included, 5,334 were placed with pre-operative antibiotics, 82 with antibiotics PIFS and 3,862 with no antibiotics. Overall risk ratio RR 0.47 (95% CI 0.39–0.58), NNT 35 (95% CI 26.3–48.2); the authors' conclusion is written as "administering prophylactic antibiotics reduced the risk of implant failures", and they note that a standardised regimen still needs to be established. span: "To assess the literature on the efficacy of prophylactic antibiotics prescribed prior to and immediately following implant surgery (PIFS)." / "Fourteen publications were collected" / "5,334 implants were placed with pre-operative antibiotics, 82 implants with antibiotics PIFS and 3,862 placed with no antibiotics" / "The overall risk ratio (RR) was 0.47 (95% CI 0.39-0.58)" / "The number needed to treat (NNT) was 35 (95% CI 26.3-48.2)." / "Administering prophylactic antibiotics reduced the risk of implant failures." / "Further investigations are recommended to establish a standardised protocol for the proper use of antibiotic regimen." caveat: Its conclusion points in a different direction from F18, and the year, inclusion criteria and endpoint definition all differ, so the two need to be presented side by side rather than one chosen over the other. Intervention-definition restriction: RR 0.47 is the overall RR including the PIFS arm, and neither the AIM nor the CONCLUSION of the original narrows the intervention to "pre-operative only" — it must not be written as "the RR for pre-operative administration"; the correct formulation is "given prior to, and given prior to with continuation immediately following (PIFS)". The PIFS arm is only 82 implants and a small share, but since it falls within the pooling it must be disclosed. Effect-size scale restriction: this unit is a risk ratio (RR), a different scale from F18's mean difference (MD), and the two cannot be converted or compared directly for magnitude. metadata as measured (2026-08-06 efetch, HTTP:200): PublicationType = `['Journal Article', 'Meta-Analysis', 'Systematic Review']`.

F21｜S1｜confidence: high｜basis: clinical_guideline｜geo: universal｜period: 2015, 4th EAO Consensus Conference The workgroup of the 4th EAO Consensus Conference listed the role of antibiotic prophylaxis in dental implant surgery, peri-implantitis, patient-reported outcome measures (PROMs) and health economics as key issues for the implant patient, and noted that antibiotic prophylaxis is an area in which conflicting opinions have long existed. span: "This included areas where conflicting opinions exists since long or recently has been expressed, like the role of antibiotic prophylaxis in dental implant surgery and peri-implantitis." / "Also areas with growing interest and concern such as patient-reported outcome measures (PROMs) and health-economy was included in this review." caveat: A 2015 consensus; subsequent evidence has been updated (see F18, F20).

F22｜S11｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: search 2014-01 to 2024-05, 5 studies included In a systematic review of prospective studies restricted to patients with an edentulous maxilla, comparing immediate / early / delayed loading (5 studies included, zygomatic implants excluded), the clinician-reported outcome measures (ClinROs) followed no standardised approach, creating substantial heterogeneity in the reported outcomes. span: "comparing immediate, early, and delayed implant loading protocols in edentulous maxilla patients receiving implant-supported prostheses" / "Zygomatic implants were excluded." / "Five studies were included, of which four compared immediate versus delayed loading and one study compared immediate versus early loading." / "ClinROs showed no standardized approach, creating significant heterogeneity in the reported outcomes." caveat: Only 5 studies were included, the subjects are limited to the edentulous maxilla, and zygomatic implants were excluded. The population restriction must not be deleted: any citation of this unit must state "edentulous maxilla", and must not use a generic phrase such as "prospective studies comparing different loading timings", which would be read as a general rule for the whole field of loading timing (the same handling standard as the population restriction in F23). This unit sits at the level of research methodology (the studies do not agree on what to measure with), and does not amount to saying that clinical treatment timelines have no standard; immediate / early / delayed loading themselves have established classificatory definitions in the literature, and this unit must not be used to infer that "how long it takes has no standard answer".

F23｜S12｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: published 2021-10, 40 articles / 35 cohort studies For implant-supported single or short-span reconstructions and for overdentures, there is no strong evidence that the timing of implant placement or loading influences patients' discomfort, their satisfaction with function or esthetics, or their overall satisfaction with treatment. span: "finally 40 articles, representing 35 cohort studies, were included." / "There is no strong evidence to support that the time for implant placement or loading of implant-supported single or short-span reconstructions or overdentures influence patients´ discomfort, satisfaction with function or esthetics or overall satisfaction with the implant treatment." caveat: The quality appraisal of most included studies raised some concerns. The population restriction must not be deleted: this unit covers only single / short-span reconstructions and overdentures, and is not a blanket negative statement about all implant treatment; the direction for full-arch fixed reconstructions differs — see F24. This unit is also a conclusion about "how patients feel", and must not be rewritten as "treatment length / timeline has no standard".

F24｜S12｜confidence: low｜basis: peer_reviewed｜geo: universal｜period: as F23 Edentulous patients rehabilitated with implant-supported full-arch fixed reconstructions were more satisfied with immediate loading over the short term, but that difference was not clear one year after treatment. span: "There is some evidence that studies including edentulous patients rehabilitated with implant-supported full-arch FDPs demonstrate more satisfied patients with immediate than for the early or delayed loaded implant reconstructions after short time, but the difference is not clear one year after treatment." caveat: The original describes this itself as "some evidence"; the strength of evidence is low.

F25｜S13｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: search to 2023-07, 12 publications included In the setting of severe periodontal disease (hopeless or questionable teeth), implant maintenance cost plus the cost of managing complications seems to surpass the cost of treating and maintaining periodontally compromised teeth. That review included 12 publications, of which 9 discussed the cost-effectiveness of preserving teeth and 3 discussed replacing periodontally compromised teeth with implants. span: "Twelve articles were included, of which nine articles discussed the cost-effectiveness of preserving teeth in severe periodontal disease and three articles discussed the effectiveness of implants that replaced the periodontally compromised teeth." / "implant maintenance cost as well as the cost associated with treating implant complications should be considered. This cost seems to surpass the cost of treatment and maintenance of periodontally compromised teeth." caveat: Limited to the severe periodontal disease setting; it is a relative-cost conclusion involving no monetary amount or currency, and cannot be extrapolated to other tooth-loss settings. Study-design restriction: the 9 plus 3 publications are an indirect juxtaposition of two sets of literature that were not compared against each other, not a head-to-head comparison in the same group of patients, and a citation must not write it as "A and B were compared". Applicability restriction: cost-effectiveness conclusions depend heavily on each country's health-care system and fee structure; the geo_scope of this article is global, and this unit must not be used to answer what treatment actually costs, or whether it is good value, in any one place.

F26｜S13｜confidence: medium｜basis: peer_reviewed｜geo: universal｜period: as F25 Implants are an effective option for replacing missing teeth, but they present complications and require strict maintenance; they are not something that needs no further attention once fitted. span: "Implants are an effective choice to replace missing teeth; however, these are not permanent, present complications, and require strict maintenance." caveat: A summary statement by the authors of that review. Source-context restriction (same paper S13 as F25): the subjects of that review are patients with severe periodontal disease (hopeless or questionable teeth) and its topic is cost-effectiveness; this unit is the opening summary of its CONCLUSIONS, not a prognostic study covering all implant patients. When cited in a high-extraction position such as a TL;DR or an FAQ, its source context must be disclosed alongside it, and F1 (meta-analysis of prospective studies with ≥20 years of follow-up, GRADE moderate) must serve as the primary anchor for long-term outcomes; this unit serves only as supporting evidence and must not on its own carry a prognostic claim about all implant patients.

F27｜S14｜confidence: low｜basis: peer_reviewed｜geo: universal｜period: published 2012, qualitative study n=10 A qualitative study (grounded theory) recorded that gatekeeping factors before treatment included cost and dental anxiety; the dentist's opinion and suggestions were the most decisive part of the decision-making process, and trust in the dentist and dental team was crucial to undergoing treatment and to the overall treatment experience. span: "Ten informants participated in the study, all of whom were treated with implant-supported fixed dentures during the past year." / "gatekeeping factors before treatment, such as cost and dental anxiety, were noted. The dentist's opinion and suggestions were the most decisive part of the decision-making process, and trust in the dentist and dental team was crucial in the decision to undergo treatment" caveat: A qualitative design with 10 informants; no proportion or representativeness may be inferred from it.

F28｜S15｜confidence: low｜basis: peer_reviewed｜geo: universal｜period: published 2024, randomised comparative study n=32 (hospitalised oral and maxillofacial surgery patients) The soft blended diet (SBD) group had a higher dietary intake figure than the full fluid diet (SFD) group (63.2% vs. 51.0%); the original reports no p value for dietary intake (a p value is reported for diet satisfaction in the same passage, P<0.0001). span: "Thirty-two patients were randomized into two groups: sixteen received SFD and sixteen received SBD." / "The SBD group had higher dietary intake (63.2% vs. 51.0%) and greater diet satisfaction (80.6 vs. 48.1, P < 0.0001) compared to SFD group." caveat: A sample of 32 in a single setting (hospitalised oral and maxillofacial surgery), not a study of outpatient implant patients, and not a study of any beverage (coffee included); this article uses it as background only and does not extrapolate it into dietary instructions after implant surgery. Statistical restriction: no statistical significance was reported for the difference in dietary intake, so it can only be described as a numerical difference and must not be written up as a demonstrated between-group difference. Design-description restriction: the PubMed PublicationType records only `Journal Article` (the title describes it as a comparative study, and the METHODS of the abstract state randomised into two groups), so this article describes it as a "randomised comparative study" and does not write RCT.

F29｜S12｜confidence: high｜basis: peer_reviewed｜geo: universal｜period: as F23 Treatment protocols in implant dentistry usually include periods of waiting for the extraction sockets to heal and for the implant to osseointegrate. span: "Protocols for implant dentistry, most frequently include periods until healing of the extraction sockets and osseointegration of the implant." caveat: A descriptive statement; it gives no number of waiting days.

13. Compliance note

• This article is health education and a summary of medical developments; it is a plain transmission of oral-health education and new medical knowledge, does not solicit patients, does not constitute medical advertising, and does not constitute a diagnosis or a treatment recommendation.
• All figures in this article are population-level research results from international literature and cannot be used to estimate the outcome for any individual patient; actual treatment and its results vary from person to person and must be assessed by a dentist against the individual situation.
• This article endorses no treatment approach, material, device or medical institution, makes no comparison between clinics, and presents no monetary amount or fee information.
• Medication (including analgesics and antibiotics) is a prescribing act, and this article deliberately lists no drug names or doses; any medication follows the prescription of the treating dentist.
• If any of the signs listed here appear — inflammation, bleeding, suppuration, wound dehiscence, graft exposure or radiographic bone loss — please return promptly for assessment by a dentist.
• The geo_scope of this article is global: it does not touch any country's insurance coverage, fee regulations or medical statutes; for local systems please see the corresponding TW canonical cards and the systems-level domain article.
• Status: draft, not through the publication gate, four language versions not yet complete, pending OP's own verification and the owner's final review.

14. Source list

Access date for all entries: 2026-08-06. Method of retrieval: NCBI E-utilities (efetch/esearch) and the PubMed website, with HTTP 200 verified in practice and spans compared verbatim.

basis counts: clinical_guideline 2 / peer_reviewed 14 / total 16 (peer_reviewed ≥6 threshold met; whole-article sources ≥8 threshold met).

Note on anchor entries not used: the P01 anchor file also holds two Taiwanese regulatory entries (Article 63 of the Medical Care Act and Article 51 of the National Health Insurance Act). Given this article's global framing, local statutes and coverage systems may not serve as a basis here, so neither entry enters the F-Units or this source list; the related content is handled uniformly by downstream links pointing to the TW canonical cards and the systems-level domain article.