Amount Of Peri-implant Bone Loss Research Articles

Evaluation of Peri-implant Bone Change and its Risk Factors in Patients Presenting to a Medical Center: A 7-year Cross-sectional Study

<p>Abstract: Objective: To evaluate the amount of peri-implant bone loss detected on digital panoramic radiographs in patient presenting to Chi-Mei medical center and to determine the factors associated with peri-implant bone loss. Materials and Methods: The panoramic radiographs of patient who presenting to Chi-Mei medical center (CMH) form year of 2008 to 2014 were screened. Those with at least one dental implant were selected and further evaluated. Submerged implants, implants with healing cap, failure implants, and implants with blurred vision were excluded. For patient level, sex, age and number of implants were recorded. For each implant obscured on the radiographs, location, type of implant-abutment connection, type of prosthesis, implant placed at CMH or non-CMH were recorded. The amount of peri-implant bone loss (PIBL) was assessed at the mesial and distal aspect using magnifying option. Clinical features of patients and implants were separately presented by descriptive statistics. Two multiple logistic regression models were also performed. Results: A total of 34.83% (650/1866) implants with detectable bone loss were identified. According to the result of chi-square test, age, implant-abutment connections and type of prosthesis were separately shown a significant influence on PIBL. Patients older than 25 years old have greater than 2.5 times risk of developing bone loss than younger patients. Comparing to the bone level with butt-joint connections, tissue level and bone level with platform switch connection separately significantly decrease 93.5% and 59.2% risk of bone loss. For the type of prosthesis evaluation, fix partial denture, overdenture and full mouth fix complete denture increased 1.97, 2.39 and 1.53 times risk of bone loss. Conclusion: Among these patients presenting to CMH with implants, the prevalence rate of peri-implant bone loss was 34.83% in implant level. Age, different implant-abutment connection designs and type of prosthesis could play a major role in peri-implant bone loss.</p> <p> </p>

The effect of implantoplasty on dental implant fracture resistance: a systematic review

An increase in dental implant placements in recent years has seen a growth in the reported cases of post-operative complications such as peri-implantitis. One of the available treatment modalities to overcome such complications is implantoplasty. Although this procedure is not new, the long-term effect of implantoplasty has not been addressed extensively. The aim of this systematic review was to investigate the change in fracture resistance of dental implants after implantoplasty. Three electronic databases and reference lists of included studies were searched to assess the potential effect of implantoplasty on implant fracture resistance. Titles and abstracts were screened by two reviewers in parallel. The extracted information regarding implant fracture resistance was reported based on the guidelines set by the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) statement. A total of 56 studies were identified, of which, nine studies were included. Narrow platform implants (<3.75 mm) were more susceptible to fracture following implantoplasty compared to wider platforms (?5 mm). Implants with internal hexagon connection may have a higher risk of fracture after implantoplasty compared to other connection designs such as external hexagon and conical connections. Other potential factors which may affect implant fracture resistance after implantoplasty include crown to implant ratio, implant material, and the amount of peri-implant bone loss. Within the limitation of in vitro studies, there is no clear evidence to demonstrate the effect of implantoplasty on implant fracture resistance. Methodological differences between the available studies did not allow for clear comparison between them. Furthermore, the limited amount of clinical reports of this resective procedure, in combination with patient and operator variability, affect the clinical assessment of this treatment modality.

At which bone level are implants explanted?

Clear guidelines when to remove an implant are missing. The aim of this study was to evaluate the amount of peri-implant bone loss at explantation by specialists. Implantology specialists were asked to provide implants explanted due to peri-implantitis with related clinical information. Early failures (survival time <12months) were analyzed separately. Questionnaires inquired age, sex, smoking, implant location, usage of bone substitutes, and implant brand. Explants were measured and bone loss was assessed using radiographs. Covariate-adjusted mixed-effects models were evaluated for bone loss and survival time. Twelve dental offices provided 192 explants from 161 patients with 99 related radiographs. Thirty-three (17.2%) explants were early failures. Excluding early failures, average survival time was 9.5±5.8years with absolute and relative bone loss of 7.0±2.7mm and 66.2±23.7%, respectively. Late failures were removed at mean bone loss of 57.7% in the maxilla and 73.7% in the mandible irrespective of survival time. In fully adjusted mixed-effects models, only age at implantation (B=-0.19; 95% CI: -0.27, -0.10) remained a significant factor for survival time. Implants exhibited significantly more relative bone loss if they were positioned in the mandible (B=17.3; 95% CI: 3.91, 30.72) or if they were shorter (B=-2.79; 95% CI: -5.50, -0.08). Though the mean bone loss (66.2%) at which implants were explanted was in accordance with the literature, its wide variation and differentiation between jaws showed that the profession has no universally accepted threshold beyond which an implant cannot be preserved.

Implant Abutment Cleaning by Plasma of Argon: 5-Year Follow-Up of a Randomized Controlled Trial.

Contamination of implant abutments could potentially influence the peri-implant tissue inflammatory response. The aim of the present study is to assess the radiographic bone changes around customized, platform-switched abutments placed according to the "one-abutment-one-time" protocol, with and without plasma of argon cleaning treatment. Thirty healthy patients with thin gingival biotype (<1 mm) and history of periodontal disease received one maxillary implant each. Immediately before abutment connection, patients were randomly assigned to control group (cleaning protocol by steaming) or test group (plasma of argon treatment). Outcome measures were: 1) success rate of implants and prostheses; 2) biologic and prosthetic complications; 3) peri-implant marginal bone loss (MBL); 4) esthetic and periodontal parameters; and 5) patient satisfaction. Neither implants nor prostheses were lost in either group at the 5-year follow-up examination. Overall, both groups showed a slight amount of peri-implant bone loss from baseline to 5 years. A statistically higher mean MBL was found in the control group compared with the test group at 6, 24, and 60 months after crown connection. Nevertheless, during the entire follow-up period, intragroup comparison demonstrated statistically significant mean MBL in the control group, but not in the test group. The test group showed a higher mean gain at the soft tissue margin, but not for the papilla. All implants showed good periodontal parameters, with no significant differences between groups. Plasma of argon could be used to disinfect implant abutments before insertion to minimize future peri-implant bone resorption.

Peri-Implant Bone Loss Evaluation Around Dental Implants Placed into Alveolar Cleft Sites

Objectives: This study was to analyze factors that affect peri-implant bone loss around dental implants placed into alveolar cleft sites. Methods: Thirty-one patients with cleft lip and palate (total 46 implants) who underwent implant treatment following secondary bone graft to the alveolar cleft were included in this study. Evaluation at the peri-implant bone level was measured using standard X-ray images. Analysis of covariance was performed using the amount of periimplant bone loss as the objective variable and sex, cleft type, age at bone grafting of alveolar clefts, time since completion of implant treatment, type of implant, length of the implant, presence or absence of vestibuloplasty, and presence or absence of bone augmentation with simultaneous implant placement as the eight explanatory variables. Results: Of the eight explanatory variables, the factors that affected the amount of peri-implant bone resorption were sex, presence or absence of vestibuloplasty, and length of the implant. The amount of peri-implant bone resorption was greater in men than in women (p=0.004), and those that underwent vestibuloplasty also tended to have a greater amount of bone resorption (p=0.002). Conclusions: In implant treatment for alveolar cleft sites, a variety of factors that are not seen in non-cleft, individuals are intricately linked. Detailed analysis of factors that affect peri-implant bone loss is therefore needed in larger a subject sample in order to establish guidelines for implant treatment of alveolar cleft sites.

Prognostic indicators for surgical peri-implantitis treatment.

Objective of this study was to identify prognostic indicators for the outcome of resective peri-implantitis treatment, by an analysis of the pooled data of two previously conducted randomized controlled trials. Data of 74 patients with peri-implantitis (187 implants) who had received resective surgical treatment were available. Primary outcome variable was failure of peri-implantitis treatment after 12months. Multilevel univariable and multiple logistic regression analyses were performed to evaluate the effect of various potentially prognostic indicators on the primary outcome. Peri-implantitis treatment was unsuccessful in 106 implants (57%) and 48 patients (67%) after 12months. In the multiple regression analysis, the variables "order of inclusion" (P=0.016) and mean bone loss at baseline (P=0.030) were significant prognostic indicators for treatment failure. To eliminate the effect of "order of inclusion," post hoc analyses were carried out in a subgroup of patients. The univariable post hoc analysis showed a significant association for smoking (P=0.015), maximum pocket depth at baseline (P=0.073), mean bone loss at baseline (P=0.003), and presence of plaque (P=0.100). In the multiple regression post hoc analysis, only the variables smoking (P=0.044) and mean bone loss (P=0.043) remained statistically significant. The outcome of surgical peri-implantitis treatment is influenced by the experience of the surgical team with the surgical procedure. The observed learning effect has consequences for clinical practice and for conducting and interpreting clinical trials on peri-implantitis treatment. Other prognostic indicators are amount of peri-implant bone loss at baseline and smoking, and to a lesser extent, probing pocket depth at baseline and presence of plaque during follow-up. Early diagnosis of peri-implantitis and control of behavioral factors are crucial in achieving peri-implantitis treatment success.

Is a grooved collar implant design superior to a machined design regarding bone level alteration? An observational pilot study.

This retrospective observational pilot study examined differences in peri-implant bone level changes (ΔIBL) between two similar implant types differing only in the surface texture of the neck. The hypothesis tested was that ΔIBL would be greater with machined-neck implants than with groovedneck implants. 40 patients were enrolled; n = 20 implants with machined (group 1) and n = 20 implants with a rough, grooved neck (group 2), all placed in the posterior mandible. Radiographs were obtained after loading (at 3 to 9 months) and at 12 to 18 months after implant insertion. Case number calculation with respect to ΔIBL was conducted. Groups were compared using a Brunner-Langer model, the Mann-Whitney test, the Wilcoxon signed rank test, and linear model analysis. After the 12- to 18-month observation period, mean ΔIBL was -1.11 ± 0.92 mm in group 1 and -1.25 ± 1.23 mm in group 2. ΔIBL depended significantly on time (P < .001), but not on group. In both groups, mean marginal ΔIBL was significantly less than -1.5 mm. Only insertion depth had a significant influence on the amount of periimplant bone loss (P = .013). Case number estimate testing for a difference between group 1 and 2 with a power of 90% revealed a sample size per group of 1,032 subjects. ΔIBL values indicated that both implant designs fulfilled implant success criteria, and the modification of implant neck texture had no significant influence on ΔIBL.

What is the optimal number of implants for removable reconstructions? A systematic review on implant‐supported overdentures

The aim of this systematic review was to assess the optimal number of implants for removable reconstructions. Medline and The Cochrane Central Register of Controlled Trials were searched and complemented by hand searching. All trials published in English to October 2011 were included, in which overdentures, supported by a various number of implants, in adult edentulous individuals were compared. Only randomized controlled trials with at least 12 months follow-up were selected. The outcomes of interest were implant loss, the amount of peri-implant bone loss, the incidence of complications and the patient satisfaction. No articles were found providing information regarding the maxilla. Eleven studies on the mandible were included for the final comparative analysis. It was possible to make a comparison among four categories: (i) 1 vs. 2 implants; (ii) 2 implants with ball attachments vs. 4 implants with a bar; (iii) 2 implants with a bar vs. 4 implants with a bar; (iv) 2 implants splinted with a bar vs. 2 unsplinted implants. For the maxilla there are no studies, at the present time, that can be utilized to address the question of how many implants should support an overdenture. For the mandible, it cannot be concluded that bone loss, patient satisfaction, or number of complications is significantly related to the number of implants supporting the overdenture. Furthermore, splinting two implants does not seem to offer additional value. Well conducted research is needed to identify the prognostic factors for long-term success.

Probing at implants with peri‐implantitis and its relation to clinical peri‐implant bone loss

To evaluate the probing depth at implants with signs of peri-implantitis before and following the removal of the prosthetic reconstructions and its relation with the peri-implant bone level as revealed by open access flap surgery. Twenty-nine patients with 89 implants with diagnosis of peri-implantitis were included in the study. The probing pocket depth at implants before (PPD-1) and following (PPD-2) the removal of the prosthetic reconstructions was measured at four sites of the implants. These measurements were also analysed in relation to the amount of peri-implant bone loss measured during peri-implant surgery. The results showed that in only 119 (37%) of the sites, the measurements were similar between PPD-1 and PPD-2; in 124 sites (39%), the difference was ±1mm, in 47 sites (15%) it was ±2mm and in the rest of the sites it was ±3mm. A high linear and statistically significant (P=<0.001) correlation between PPD-2 and the bone loss measured at implants for all and single surfaces was observed (r=0.67, range 0.64-0.69), while PPD-1 yielded a weak and no statistically significant correlation (r=0.35, range 0.27-0.42). The analysis of the bone loss at implants showed that 59 implants (66%) had an amount of bone loss that was similar at all the four surfaces, while in 30 implants, the bone loss differed for the various sites. A higher extent of bone loss was often detected at the buccal compared with the other sites. The results of this study yielded differences in the pocket probing measurements at implants with or without the prosthetic reconstruction in place and that the probing pocket depth following the removal of the prosthesis had a high correlation with the amount of bone loss at implants assessed during surgery.

Bone level changes at implants supporting crowns or fixed partial dentures with or without cantilevers

The aim of this study was to analyze whether or not a cantilever extension on a fixed dental prosthesis (FDP) supported by implants increased the amount of peri-implant bone loss or technical complications compared with reconstructions without cantilevers. Fifty-four partially dentate patients with a total of 54 FDPs supported by 78 implants were enrolled in the study. Twenty-seven FDPs were with cantilever and 27 FDPs were without cantilever (control group). All FDPs were supported by one or two implants and were located in the posterior maxilla or mandible. The primary outcome variable was change in peri-implant marginal bone level from the time of FDP placement to the last follow-up visit. FDPs were under functional loading for a period of 3 up to 12.7 years. Statistical analysis was carried out with Student's t-test. Regression analyses were carried out to evaluate the influence of confounding factors on the peri-implant bone level change. In addition, implant survival rates were calculated and technical complications assessed. After a mean observation period of 5.3 years, the mean peri-implant bone loss for the FDPs with cantilevers was 0.23 mm (SD+/-0.63 mm) and 0.09 mm (SD+/-0.43 mm) for FDPs without cantilever. Concerning the bone level change at implants supporting FDPs with or without cantilevers no statistically significant differences were found. The regression analysis revealed that jaw of implant placement had a statistically significant influence on peri-implant bone loss. When the bone loss in the cantilever group and the control group were compared within the maxilla or mandible separately, no statistically significant difference was found. Implant survival rates reached 95.7% for implants supporting cantilever prostheses and 96.9% for implants of the control group. Five FDPs in the cantilever group showed minor technical complications, none were observed in the control group. Within the limitations of this study it was concluded that cantilever on FDPs did not lead to a higher implant failure rate and did not lead to more bone loss around supporting implants compared with implants supporting conventional FDPs. In contrast to these results more technical complications were observed in the group reconstructed with cantilever.

Feasibility and Influence of the Microgap of Two Implants Placed in a Non‐Submerged Procedure: A Five‐Year Follow‐Up Clinical Trial

The aim of this study was to evaluate the feasibility of using a two-piece implant system in a non-submerged procedure and to study the impact of the microgap between the implant and abutment. Sixty edentulous patients (Cawood Class V-VI) participated in this study. After randomization, 20 patients received two two-piece implants placed in a non-submerged procedure, 20 patients received two two-piece implants placed in the traditional submerged procedure, and 20 patients were treated with two one-piece dental implants placed in the traditional non-submerged procedure. The implants were placed in the mandible for overdenture treatment. A standardized clinical evaluation was performed and radiographs were taken immediately after denture insertion and yearly up to 5 years. Peri-implant samples were collected 12, 36, and 60 months after loading with sterile paper points and analyzed for the presence of putative periodontal pathogens using culture techniques. One two-piece implant of the non-submerged group and one two-piece implant of the submerged group were lost after 6 and 12 months, respectively. After 5 years of functioning, no significant clinical, radiological, or microbiological differences were found between the three groups. No association was found between the level of the microgap and the amount of bone loss. The results of this study indicate that dental implants designed for a submerged implantation procedure can also be used in a non-submerged procedure and may be as predictable as when used in a submerged procedure or as one-piece implants. The microgap at the crestal level in two-piece implants does not appear to have an adverse effect on the amount of peri-implant bone loss.