The effect of brushing discomfort on peri-implant health in sites exhibiting inadequate keratinized mucosa width: Across-sectional study.

Abstract

The aim of this cross-sectional study was to evaluate the effect of brushing discomfort (BD) on peri-implant health in sites exhibiting inadequate keratinized mucosa (KM) width. Patients presenting with at least one implant exhibiting KM <2 mm and in function for ≥1year were eligible for inclusion. BD was assessed with the visual analogue scale (VAS), and implants were classified into two groups: Absence (aBD; VAS=0) or Presence (pBD; VAS > 0) of BD. Bleeding on probing (BoP), modified plaque index (mPI), probing depth (PD), clinical attachment level (CAL), suppuration (Sup), and marginal bone level (MBL) were recorded. Mann-Whitney, chi-square test, and a multilevel model were used for analysis. Fifty-nine patients with 155 dental implants were analyzed, of which 60 presented no BD, and 95 presented some level of BD. BoP, PD, CAL, and MBL were significantly higher in the pBD than in the aBD group (p < .05). The prevalence of peri-implant diseases at implant level was also higher in the pBD group than in the aBD group. However, after controlling for confounding factors, only mPI showed an effect on BoP. In addition, difficulty to perform oral hygiene was statistically higher in the pBD group. The findings of the present study suggest that although BD around implants exhibiting KM <2 mm did not influence tissue inflammation, it could represent a symptom of peri-implant diseases. Further clinical trials assessing the long-term effect of BD must be considered to better ascertain its effects on peri-implant health.