Evidence hierarchy
When multiple sources address the same question, we lean on the higher tiers first and only descend when the higher tiers are silent.
- Tier 1 — Clinical practice guidelines & consensus statements. ADA evidence-based guidelines, AAOMS parameters of care, ITI Treatment Guides & consensus, EAO consensus, EFP/AAP joint workshops, Cochrane systematic reviews.
- Tier 2 — Peer-reviewed systematic reviews & meta-analyses. Published in Clinical Oral Implants Research, Journal of Prosthetic Dentistry, Journal of Periodontology, International Journal of Oral & Maxillofacial Implants, and equivalent indexed journals.
- Tier 3 — Peer-reviewed primary literature. Randomized controlled trials, prospective cohorts, and large retrospective studies from the same journal set.
- Tier 4 — Regulatory & public-health sources. FDA device data, CDC infection-control standards, WHO documents, NIH/NIDCR patient information.
- Tier 5 — Reference textbooks. Contemporary Fixed Prosthodontics; Contemporary Implant Dentistry; Newman & Carranza's Clinical Periodontology; for anatomy and mechanism only.
- Tier 6 — Expert clinical opinion. Used only where higher tiers are silent, and labeled as opinion in the text.
Sources we do not treat as authoritative
- Clinic websites, blogs, and testimonials.
- Manufacturer marketing materials, sponsored white papers, and continuing-education promotional decks.
- Anonymous forum threads and unverified social media content.
- Predatory or non-indexed journals.
Primary vs. secondary sourcing
Wherever a statistic could be misrepresented by a chain of citations — for example, implant survival rates or graft success percentages — we cite the primary study, not a secondary source that quotes it. When we rely on a consensus document that has aggregated primary data, we say so.
Verification steps before publication
- Each quantitative claim is tied to a specific source in an internal draft.
- An editor checks that the source actually supports the claim, in context.
- Where evidence is heterogeneous, ranges are presented instead of a single number.
- A licensed dental professional reviews the page against current consensus.
- Broken source links are re-verified on the site's review cadence.
Corrections
If a source is retracted, superseded by newer consensus, or misread by our editors, the affected page is corrected and dated. See our editorial policy for how corrections are documented.