Abstract

ObjectivesThe aims of this retrospective study were to report data on the prevalence of retrograde peri-implantitis (RPI) in a single-center in a 20-year observation period and to evaluate implant survival after surgical treatment.Materials and methodsA retrospective cohort study was conducted screening all patients who underwent implant treatment in a private practice. Patients were enrolled if they had one or more implants showing a radiolucency around the implant apex, without implant mobility. Furthermore, clinical symptoms of RPI and days from symptoms’ appearance after implant placement were also collected, as well as periodontal and endodontic status of nearby teeth. All patients were treated with the same surgical approach: antibiotic therapy, mechanical curettage, chemical decontamination and xenograft application.ResultsOut of the 1749 implants placed, only 6 implants were classified as affected by RPI, with a prevalence of 0.34%. Clinical symptoms of RPI (pain, swelling, dull percussion or fistula presence) varied among patients and were reported after a mean period of 51.83 ± 52.43 days.ConclusionsRPI was successfully treated with surgical curettage and bone substitute application and all implants are still in place after a mean follow-up of 8.83 ± 5.34 years.Clinical relevanceBacteria from teeth with failed endodontic treatment or residual lesions might be reactivated by drilling for implant osteotomy, with subsequent colonization of the implant apex and possible failure before prosthetic loading. Therefore, it might be recommended to take a periapical x-ray at implant placement and after 6–8 weeks in order to intercept RPI before prostheses delivery.

Highlights

  • Implant-supported prosthetic rehabilitation is considered a predictable and successful option for replacing missing teeth in partially and fully edentulous patients [1,2,3]

  • Among the 1749 dental implants placed in the study period, only six were affected by retrograde peri-implantitis (RPI), with a prevalence of 0.34%

  • Speculating on the possible aetiology of RPI in implants included in the present study, a common finding was that there were no implants with adjacent endodontically treated teeth

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Summary

Introduction

Implant-supported prosthetic rehabilitation is considered a predictable and successful option for replacing missing teeth in partially and fully edentulous patients [1,2,3]. Peri-implantitis is an irreversible plaque-related inflammatory lesion and the first cause of late implant failure [11]. It is defined, by the 2017 World. The prevalence of periimplantitis is still controversial, depending primarily on the case definition adopted: a recent systematic review found out that around 23% of dental implants are affected by periimplantitis and 43% by mucositis [13]. Due to the heterogeneity of the case definition, a recent systematic review [14] downgraded the peri-implantitis rate 18.5% at the patient level and 12.8% at the implant level

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