Are “Human Factors” the Primary Cause of Complications in the Field of Implant Dentistry?

Abstract

Complications in medicine and dentistry are usually analyzed from a purely technical point of view. Rarely is the role of human behavior or judgment considered as a reason for adverse outcomes. When the role of human factors is considered, these are usually described in general terms rather than specifically identifying the factors responsible for an adverse event. The impact of cognitive and behavioral factors in the explanation of adverse events has been studied in other high-stakes areas such as aviation and nuclear power. Specific protocols have been developed to reduce rates of human error, and, where human error is unavoidable, to lessen its impact. This approach has dramatically reduced the incidence of accidents in these fields. This article aims to review how a similar approach may prove valuable in the reduction of complications in implant dentistry.

Data on implant failures will show different results depending on how patients are compiled and analyzed: A retrospective study on 3902 individual patients treated either with one single implant or implants in the edentulous upper jaw

“…Treatment is presumed to follow a strict clinical protocol in a prospective study, and strict follow‐up programs ensure that both the dentists and the patients know that they are being monitored and will be evaluated. Check‐lists and strict protocols have been used routinely in aviation for decades to increase security, and similar check‐list protocols for the treatment of patients have been discussed and evaluated . Thus, the use of the predesigned WHO check‐list for emergency surgery has significantly reduced the perioperative mortality rate, and it can be assumed that the use of a prospective study design in dentistry may also have a positive impact on treatment results per se.…”

Model‐less digital workflow for the replication of an existing complete fixed implant‐supported prosthesis using an intraoral scanner

“…The digital, model-less workflow did efficiently cut down turnaround time, as the process was more efficient than conventional methods, 1,8 and diminishing the possibility of human errors. 10 However, the implementation of such workflow proved to be challenging, requiring advanced skills in clinical and laboratory procedures. A summary of key the clinical steps involved in the proposed digital workflow are enlisted in Table 1.…”

“…By scanning directly intraorally, we could produce the restoration more efficiently by reducing clinical and laboratory fabrication steps; avoiding inaccuracies that can occur from impression materials and gypsum deformation; requiring less intervention along the processes; and reducing the chance of human errors. [8][9][10] However, there are few reports of fullarch intraoral scans for CAFIP fabrications, and one of the main reasons may be the difficulties related to record hard tissue data points in complete-arch cases, using intraoral scanners. 11,12 As digital software, hardware, and new materials keep developing, new workflow possibilities are emerging.…”

Concepts for prevention of complications in implant therapy

“…Treatment concepts are required to maintain cleansability of the prosthetic restoration and control of infections. Renouard et al considered that human factors play an important role as one of the causes of complications in implant dentistry. These human errors have been studied in other high‐stakes areas, such as aviation and nuclear power, and may create dramatic events in the future of implant dentistry, especially when this is based on weekend continuing education courses without formal comprehensive clinical training under direct supervision.…”