Predictability is a term commonly used in dentistry, with this term we wish to forecast possibly the good long-term outcome of dental interventions. Maybe that this term is sometimes abused since often is given to interventions which have no long-term data to support it, but is definitively a “reassuring” term for dentists (and patients).

In implantology for instance we still lack solid evidence on the long-term outcome (more than 10 years) for short implants, zygomatic implants, pterygoid implants, and why not also for the reborning subperiosteal implants, all procedures aimed at the rehabilitation of the most difficult cases to treat, i.e. the very atrophic edentulous jaws.

In the absence of evidence, can we replace it with simplistic (and often optimistic) forecasts as we are used to do? Sometimes forecasts are definitively right, but sometimes are not.

Please allow me a parallelism with the current world situation, has anybody predicted a COVID pandemic followed now by a sudden real and dramatic war at the boundaries of Europe? Even more, were we prepared for these catastrophic events?

My impression is that the world was almost totally unprepared to face what has happened. Some events can be absolutely unpredictable, or can be predicted but without knowing a precise date. So what can we realistically do? Well we have to be prepared and to properly monitor our environment. This applies to the actual life of everybody, to governments, as well as to dentistry. In dentistry, we need to monitor our treatments, possibly to intercept early signs or complications which may be prodromic of bigger problems and we should be prepared with plan B and plan C.

When possible, we need to choose among those treatment options which allow us still to have a plan B and possibly a plan C, otherwise we could end-up in a catastrophic failure of difficult solution.

So when possible, choose evidence-based therapeutic options, and when robust evidence is lacking, as it happens in most of the cases, go for common sense, but please monitor closely and reports the data, having a prospective global approach and not a retrospective one.

Marco Esposito

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