In recent years, patients’ needs have increased in terms of the esthetic and functional outcome of the dental restoration. PROMs have been reported in several studies and represent a well-described non-invasive method to measure patient’s satisfaction with these needs; however, they might present a lack of standardization [39, 40] due to the very subjective view on esthetics or functionality of the patients. Therefore, the chosen parameters considered to be important by the investigator might not correlate with the patients’ subjective satisfaction about the functional and esthetic results [41]. On the other hand, it is well-known from other medical fields that self-evaluation programs or forms for their health status increase the patient’s compliance with medication or treatment procedures considerably [42]. In analogy, one can assume that the filling out of the PROMs increases the motivation of the patients to adhere to oral hygiene with impact on the survival rate of the implants. In this observational study, patients’ satisfaction including esthetical and functional parameters as well as the oral hygiene status was evaluated. The data revealed that 87.5% of the patients were maximally satisfied and 12.5% satisfied at the 5-year follow-up appointment. The reason for these good results might be the excellent compliance of the patients in terms of oral hygiene which was also proven by the excellent results of the plaque and sulcus bleeding indices.

Observational studies often lack standardized treatment procedures. In this study different treatment protocols were applied beginning with the type of implantation (immediate versus delayed implantation), the healing procedure (submerged or transgingival healing), and the prosthetic restorations (screw- versus cement-retained; single crowns and fixed partial dentures). Additionally, the less stringent inclusion criteria than in (randomized) controlled clinical trials promote an increased heterogeneity of the study patients, but conversely may possibly reduce the risk of any bias toward more favorable outcomes. In summary, despite these possible limitations, the present results of implant survival, hard and soft tissue adaption as well as the patients’ satisfaction reflects the reality of implant treatment success in daily dental practice with reservation considering the defined indications.