Clinician preferences for single-unit implant restoration designs and materials: A survey of the membership of the Pacific Coast Society for Prosthodontics

Statement of problem: Clinical research has difficulty keeping pace with the rapid evolution of materials, protocols, and designs of single-unit implant restorations. The clinical design preferences of prosthodontics for different clinical scenarios are lacking. Purpose: The purpose of this cross-sectional survey was to determine the current prevalence of usage of various treatment options and materials for single-unit implant-supported restorations. Material and methods: From August to September of 2022, a survey invitation was sent to members of the Pacific Coast Society for Prosthodontics (PCSP). The survey was hosted online and asked 37 questions related to the materials, protocols, and design preferences for single-unit implant-supported restorations in various clinical scenarios. The prompts included the suggestion that answers should be based on preferences for the “ideal” treatment of a hypothetical patient seeking implant treatment for the replacement of a single missing tooth. Results: Of 133 questionnaires sent via email, 35 were returned. The results are presented with histograms that use color coding as an experience proxy metric. A total of 87% of respondents was in private practice, and 60% reported having restored more than 1000 single-unit implant restorations. For the replacement of a single maxillary central incisor under ideal conditions and angulation through the palatal surface, respondents preferred bone level implants (93%) and screw-retained restorations (80%), with 50% of those being zirconia with a titanium abutment and 21% being cast metal-ceramic. For an identical scenario, except that the angulation would be through the facial surface, respondents preferred the angled screw system (55%) and cemented (41%) restorations. For the replacement of a single missing mandibular molar under ideal conditions, respondents preferred bone level implants (79%) and screw-retained restorations (79%), with 70% of those being zirconia with a titanium abutment and 17% being cast metal-ceramic. Conclusions: While a wide range of protocols, designs, and materials exist for the replacement of a single missing tooth, these results provide a snapshot of current single-unit implant prosthodontic preferences in the Western United States and Canada.