Abstract

Background and Objectives: Peri-implantitis is a common finding among patients with dental implants. There is no consensus regarding the treatment of this disease, but in many cases, surgical treatment is common practice. A histopathological analysis is not an integral part of suggested protocols. The present study investigated the clinical and histopathological parameters of lesions mimicking peri-implantitis and correlated them with the outcome and follow-up data. Materials and Methods: The study included 65 consecutive biopsies taken from peri-implantitis patients between 2008–2019. Results: The three common diagnoses were fibro-epithelial hyperplasia 20 (30.7%), pyogenic granuloma 16 (24.6%), and peripheral giant cell granuloma 15 (23%). There were 18 cases of recurrent lesions in the study group (27.7%). The recurrence rate was the highest in peripheral giant cell granuloma (8, 12.3%), versus 6% in pyogenic granuloma and fibro-epithelial hyperplasia. These differences in the recurrence rate were statistically significant (p = 0.014). Conclusions: This study emphasizes the necessity of submitting tissue of peri-implantitis cases for histopathological analysis since the more locally aggressive lesions (peripheral giant cell granuloma and pyogenic granuloma), which comprise nearly half of the cases in this study, do not differ in clinical or radiographic characteristics from other peri-implant lesions.

Highlights

  • Peri-implantitis (PI) is a common condition involving soft tissue and bone surrounding dental implants

  • A key topic regarding the proposed etiology of peri-implantitis is the type of restoration used; numerous studies address the issue of cement-retained versus screw-retained restorations and marginal bone loss around implants

  • Two recent studies demonstrated that cemented press-fit abutments showed a lower risk of peri-implantitis when compared with screwed abutments

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Summary

Introduction

Peri-implantitis (PI) is a common condition involving soft tissue and bone surrounding dental implants. A key topic regarding the proposed etiology of peri-implantitis is the type of restoration used; numerous studies address the issue of cement-retained versus screw-retained restorations and marginal bone loss around implants. There is no consensus whether cement-retained implant-supported restorations show less marginal bone loss when compared with screw-retained restorations. Two recent studies demonstrated that cemented press-fit abutments showed a lower risk of peri-implantitis when compared with screwed abutments. This can be explained by a better seal of the implant-abutment connection, which reduces bacterial infiltration and micromovement [3,4,5,6,7]. These differences did not reach the threshold for statistical significance

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