The National Dental Practice-Based Research Network Dental Implant Restoration Registry to Evaluate Dental Implant Outcomes in Community Practice Settings: Protocol for a Prospective Observational Study

Background: Dental implants are a widely used therapeutic option for tooth replacement; however, biological and prosthetic complications may compromise implant success. While prior research has largely focused on academic or specialty settings, data on implant outcomes in community dental practices remain limited. Objective: This study aims to establish a national registry within the National Dental Practice-Based Research Network to evaluate the incidence of and factors associated with biological and prosthetic complications following implant therapy in community practice settings. Methods: This prospective observational cohort study plans to include approximately 2000 implant restorations from 1550 patients receiving implant restorations from 150 practitioners across 6 regional network nodes. Clinical, implant, and prosthetic characteristics will be recorded at baseline, with annual follow-up visits collecting data on complications, implant failures, prosthetic issues, and patient-reported outcomes. Digitized radiographs will be centrally reviewed for peri-implant bone changes, emergence angle, and prosthetic fit. The primary outcome is the incidence of biological and prosthetic complications. Secondary analyses will evaluate patient-centered outcomes and identify risk factors for complications. Multilevel mixed-effects regression and time-to-event analyses will be used to account for clustering and censored data. Results: Of 430 practitioners who expressed initial interest, 187 (43.5%) completed training and began patient enrollment, with 143 (76.5%) of these practitioners enrolling at least one participant. A total of 1453 patients were registered between August 2022 and October 2024. Practitioner activity and enrollment peaked in late 2023. Overall, 1178 (81.1%) baseline patient surveys and 1453 (100%) baseline clinical forms were completed, covering 2087 dental implant restorations. Conclusions: The registry will generate robust, real-world evidence on implant-related complications and their predictors in community practice. The findings will enhance clinical decision-making; support personalized risk assessment; and, ultimately, improve patient outcomes in implant dentistry.