A New Complexity Index in Implant Dentistry: Position Statement of the Implant Dentistry Study Consortium

Background: The growing complexity of implant dentistry necessitates advanced frameworks to guide treatment planning, enhance clinical outcomes, and streamline surgical execution. This article proposes the IDSC Complexity Index, a novel classification system. Materials and Methods: A retrospective study was conducted using data collected from 4,201 patients who underwent 20,154 dental implant procedures between January 2002 and October 2024. Patients aged 18–95, including both medically healthy and compromised individuals, smokers, and diverse socioeconomic and ethnic groups, were included. Exclusions were limited to contraindications for implant surgery. The IDSC classification system divides implant sites into five zones, starting with simpler areas like the anterior mandible and progressing to the most complex regions such as the posterior maxilla with sinus lift requirement. Results: Analysis of 20,154 samples revealed variations in implant placement by location and classification. The highest percentage of implants was in the posterior mandible (32%, Class III), while the posterior maxilla requiring sinus elevation (5%, Class V) was the lowest. Surgical time ranged from 19 minutes (Class I) to 50 minutes (Class V). Treatment costs spanned from $790 (Class I) to $1,251 (Class V). The number of procedures per implant also varied, with Class I requiring one procedure on average, increasing to 3.0 procedures for Class V, which involved the most ancillary interventions. Conclusion: Implant placement in different areas of the oral cavity has an escalating effect on time, cost and number of ancillary procedures. Keywords: Implant site classification, IDSC Complexity Index, Treatment planning, Implant dentistry; SAC classification.