Abstract
The aim of this study is to evaluate factors associated with long-term peri-implant bone-loss and to create a statistical model explaining bone-loss. The dental records in a private periodontal practice were screened for implant-patients with a minimal follow-up period of 8 years with periapical radiographs at implant-placement (T0) and last follow-up (Tf). Collected data included demographics, general health, medications, periodontal parameters, implant parameters, bone augmentation procedures, restoration and antagonist data, number of supportive periodontal appointments (SPT), and radiographic bone-loss between T0 and Tf. Bivariate and Mixed Logistic Regression analyses were performed. “Goodness-of-fit” of the model was elaborated with Receiver Operating Characteristic Curve (ROC) analyses. Thirty-seven patients receiving 142 implants were included. Mean clinical follow-up period was 11.7 ± 3.7 years (range 8–23). Most implants 64.4% were SPT-maintained more than twice a year. Patients with osteoporosis and smokers were prone to increased radiographic peri-implant bone-loss. External-hex implants placed without guided bone regeneration (GBR) and implants 10–12 mm long and diameter of 3.7–4 mm showed less peri-implant bone-loss. The model’s Area Under the Curve (AUC) was 76.9% (Standard Error 4.6%, CI 67.8%–86%).
Highlights
Installation of dental implants for fixed or removable rehabilitation has become a common practice in the last decades [1,2], and its high rates of survival and success are well documented [3,4].It is currently accepted that implants go through periods of physiological remodeling after implant placement and after completion of implant-supported prosthesis, after which comes a period of steady state [5]
Patients with osteoporosis and smokers were prone to increased radiographic peri-implant bone-loss
Periapical radiographs are the standard imaging tool to monitor peri-implant bone level, which manifests itself as physiological remodeling of crestal bone loss varying between 0.5 and 2 mm from implant installation to initial loading [6,7] followed by a steady state when the average annual decrease in peri-implant bone level is less than 0.1 mm/year [8]
Summary
Installation of dental implants for fixed or removable rehabilitation has become a common practice in the last decades [1,2], and its high rates of survival and success are well documented [3,4].It is currently accepted that implants go through periods of physiological remodeling after implant placement and after completion of implant-supported prosthesis, after which comes a period of steady state [5]. The current classification of an implant with peri-implantitis in the absence of a radiograph after initial healing/loading comprises bone loss ≥3 mm apical of the most coronal portion of the intra-osseous part of the implant together with probing pocket depth of ≥6 mm and bleeding on probing [9]. This definition takes into account the initial physiological remodeling as well as bone loss during the ensuing period
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