Incidence Of Peri-implantitis Research Articles

History of periodontitis as a risk factor for implant failure and incidence of peri-implantitis: A systematic review, meta-analysis, and trial sequential analysis of prospective cohort studies.

Dental implants are widely employed as dependable replacements for lost teeth. However, it is crucial to establish, solely through prospective cohort studies, whether a history of periodontitis indeed constitutes a significant risk factor for implant failure. A systematic literature search was conducted in October 2022 in several electronic databases with subsequent manual updates. Only original prospective cohort studies evaluating the implant (loss) rate ≥1 year after implant loading were included. Logarithmic risk ratio and weighted mean differences were calculated. Study results were summarized using random effects meta-analyses evaluated by trial sequential analyses. The Newcastle-Ottawa scale evaluated study bias and the GRADE approach assessed the certainty/quality of the evidence. A total of 14 publications reporting on 12 prospective cohort studies were included. Low evidence certainty/quality evidence due to the absence of randomized clinical trials revealed significantly greater odds of failure in patients with a history of periodontitis at follow-ups both after ≤5 years (RR = 1.62; 95% CI: 1.71-2.37; p = 0.013) and >5 years (RR = 2.26; 95% CI: 1.12-4.53; p = 0.023). The incidence of peri-implantitis (RR = 4.09; 95% CI: 1.93-8.58; p < 0.001) and the weighted mean (WM) of marginal bone loss (WM difference = 0.75 mm; 95% CI: 0.18-1.31; p < 0.05) were statistically significantly greater in the periodontally compromised group, whereas there was no significant difference between the two groups for peri-implant probing depth. A history of periodontitis can be considered a significant risk factor for incident implant failure, peri-implantitis, and greater marginal bone loss.

The effect of one-time abutment placement on clinical and radiographic outcomes: A 5-year randomized clinical trial.

The aim of this study was to evaluate the long-term (5 years) clinical efficacy of the one-abutment one-time protocol (test) versus the standard of care by placing the definitive abutment on the day of the prosthetic delivery (control). In this study, 39 subjects with 60 implants were randomly allocated to either the test or the control group. Changes in the radiographic interproximal bone levels (DIB), modified sulcus bleeding index, probing depth, modified plaque index, papilla fill (Jemt score), incidence of peri-implantitis and peri-implant mucositis as well as patient-reported outcomes measures (PROMs) were collected and compared at 1, 3 and 5 years. At 5 years, the control group showed a greater, although not statistically significant, change in mean DIB values (0.97 mm vs. 0.53 mm). Regarding the other clinical parameters evaluated, no statistically significant differences were observed between groups at any time point. At 5 years, 51% of the implants presented peri-implant mucositis (25.5% in the control and 23.5% in the test), and only one implant in the test group developed peri-implantitis. The connection and disconnection of healing abutments during the healing period was not associated with higher long-term bone loss. Clinical outcomes and PROMs were similar between groups.

Effect of Glycine Subgingival Sandblasting on the Incidence of Peri-Implantitis and Expression of Inflammatory Factors in Gingival Crevicular Fluid in Patients with Titanium-Nickel-Chromium Alloy Porcelain-Fused-To-Metal Crowns

This research was aimed to demonstrate impacts of glycine subgingival sandblasting on peri-implantitis (PI), periodontal clinical parameters, and inflammatory factor expression in gingival crevicular fluid (GCF) in patients with titanium-nickel-chromium (TiNiCr) alloy porcelain-fused-to-metal crown (APC) restorations. A total of 159 patients with TiNiCr APCs were randomly rolled into glycine subgingival sandblasting group (Exp 1 group), erythritol subgingival sandblasting group (Exp 2 group), and conventional scaling and root planing (SRP) treatment group (Con group), with 53 patients in each group. The quantity of oral biofilm was assessed based on plaque staining, and the plaque index (PLI), bleeding index (BI), probing depth (PD), and clinical attachment level (CAL) preoperatively (baseline) and at 3-, 6-, and 12-months postoperatively in various groups were compared. Microbial species and quantities in the GCF were determined using microbial counting, and the incidence of PI postoperatively was calculated in each group. The inflammatory cytokines tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, and IL-6 in the GCF were measured using enzyme-linked immunosorbent assay (ELISA). The results showed that at 3-, 6-, and 12-months postoperatively, the PLI, BI, PD, CAL, TNF-α, IL-1β, and IL-6 in Exp 1 group were dramatically inferior to those in Con group (P &lt; 0.01). The PLI, BI, PD, CAL, bacterial counts (rods, cocci, and spirochetes) in Exp 2 group were inferior to those in Con group (P &lt; 0.05) at the same time points. Furthermore, the PLI, BI, PD, CAL, TNF-α, IL-1β, and IL-6 in Exp 1 group were inferior to those in Exp 2 group (P &lt; 0.05) at 3-, 6-, and 12-months postoperatively. The incidence of PI postoperatively in Exp 1 and Exp 2 groups was 5.66% and 3.77%, respectively, which was dramatically inferior to Con group’s incidence of 9.43% (P &lt; 0.05). These findings indicate that glycine subgingival sandblasting can greatly enhance the periodontal condition of patients undergoing TiNiCr APC restorations, reduce the incidence of PI, and lower the levels of inflammatory factors in the GCF.

Impact of the Habit of Alcohol Consumption on the Success of the Implants: A Retrospective Study

ABSTRACT Introduction: A recent study has demonstrated that social factors have an impact on the condition of dental implants. The present investigation investigated how varied alcohol intake quantities might alter the condition of dental implants and related peri-implant inflammation. Materials and Methods: This retrospective research was piloted in a tertiary care center, and implants inserted between 2010 and 2022 were evaluated through a retrospective cohort analysis. Within 3 months following implant implantation, information on alcohol intake was gathered from the health maintenance records and employed as the predictor variable. The implant results as well as peri-implantitis were examined at follow-up visits. Using the logistic regression model, the Wald test analysis analyzed the statistical consequences of each parameter. The findings were translated using an odds ratio that was determined with a 95% confidence level. The data were generated and analyzed using descriptive statistics, with statistical significance defined as P &lt; 0.05. Results: At the time of implant placement, the enrolled patients were 59 ± 11.3 years old on average. The median time before peri-implantitis occurred was 31.3 ± 22.2 months. Within the first 2 years following implant implantation, the majority of people experienced peri-implantitis. The incidence of peri-implantitis was the lowest among light and moderate alcoholics (11.5%) and the highest among heavy alcoholics (46.2%). Moderate alcohol use was associated with a 79.1% decrease in peri-implantitis when compared to not drinking (P = 0.0365), whereas light alcohol consumption was connected to a 51.3% decrease (P = 0.026). The incidence of peri-implantitis among heavy drinkers was significantly significant (P = 0.0001). Conclusion: According to the findings of the current retrospective cohort analysis, drinking alcohol at mild-to-moderate levels is connected to a reduction in the incidence rate of peri-implantitis compared to heavy drinkers. In contrast, high alcohol consumption was found to be associated with an increase in the prevalence of peri-implantitis among the participants who had dental implants.

Investigating the Long-Term Success and Complication Rates of Zirconia Dental Implants: A Prospective Clinical Study.

Zirconia dental implants have gained attention due to their biocompatibility and aesthetics. However, research on their extended success and complication rates is limited. A prospective clinical study involved the placement of 30 zirconia dental implants in patients requiring tooth replacement. The implants were followed up for five years. Success was defined as the implant remaining stable and functional. Complications, including peri-implant mucositis and peri-implantitis, were monitored. Statistical analysis included descriptive statistics, Chi-square test, and P-values were set at P < 0.05. The long-term success rate of zirconia dental implants was found to be 93.3%. Among the 30 implants, only 2 exhibited failure. The most common complication was peri-implant mucositis, occurring in 16.7% of implants. Notably, the incidence of peri-implantitis was limited, observed in 6.7% of implants. Statistical analysis showed significant associations between implant failure and smoking (P = 0.021). Zirconia dental implants demonstrated a high long-term success rate of 93.3% over five years. Peri-implant mucositis was the predominant complication, with a relatively low occurrence of peri-implantitis. The findings underscore the potential of zirconia implants for reliable dental implantation. Addressing modifiable risk factors, such as smoking, could further enhance implant success. Continued research is recommended to validate and expand upon these outcomes.

Prevalence of peri-implantitis after alveolar ridge preservation at periodontitis and nonperiodontitis extraction sites: A retrospective cohort study.

Periodontitis is the main indication for dental extraction and often leads to peri-implantitis (PI). Alveolar ridge preservation (ARP) is an effective means of preserving ridge dimensions after extraction. However, whether PI prevalence is lower after ARP for extraction after periodontitis remains unclear. This study investigated PI after ARP in patients with periodontitis. This study explored the 138 dental implants of 113 patients. The reasons for extraction were categorized as periodontitis or nonperiodontitis. All implants were placed at sites treated using ARP. PI was diagnosed on the basis of radiographic bone loss of ≥3 mm, as determined through comparison of standardized bitewing radiographs obtained immediately after insertion with those obtained after at least 6 months. Chi-square and two-sample t testing and generalized estimating equations (GEE) logistic regression model were employed to identify risk factors for PI. Statistical significance was indicated by p < 0.05. The overall PI prevalence was 24.6% (n = 34). The GEE univariate logistic regression demonstrated that implant sites and implant types were significantly associated with PI (premolar vs. molar: crude odds ratios [OR] = 5.27, 95% confidence intervals [CI] = 2.15-12.87, p = 0.0003; bone level vs. tissue level: crude OR = 5.08, 95% CI = 2.10-12.24; p = 0.003, respectively). After adjustment for confounding factors, the risks of PI were significantly associated with implant sites (premolar vs. molar: adjusted OR [AOR] = 4.62, 95% CI = 1.74-12.24; p = 0.002) and implant types (bone level vs. tissue level: AOR = 6.46, 95% CI = 1.67-25.02; p = 0.007). The reason for dental extraction-that is, periodontitis or nonperiodontitis-was not significantly associated with PI. ARP reduces the incidence of periodontitis-related PI at extraction sites. To address the limitations of our study, consistent and prospective randomized controlled trials are warranted.

Incidence of Peri-Implantitis, Technical and Biological Complications of Single Implants Placed with Flap or Flapless Surgery-A 10-12-Year Case-Series.

Long-term follow-up of single implants and crowns is scarce, especially when inserted using flapless surgery. Evaluate survival, peri-implantitis incidence, and technical/biologic complications of solitary implants/crowns after 10-12 years of function. 49 patients with 53 single implants, initially operated with a one-stage flap (F) or flapless (FL) surgery and delayed loading, were recalled. Implant survival, radiographic bone-level changes compared to baseline, peri-implant health, and soft tissue aesthetics were registered. Differences in implant level between and within groups were statistically tested using the Mann-Whitney U-Test and Wilcoxon Signed Ranks Test, respectively. 36 patients with 40 implants were reassessed, yielding 100% implant and 97.5% crown survival. The bone loss in F (n = 19) was 0.56 mm (SD 0.89; range -0.9-2.02) and -0.85 mm (SD 0.98; range -2.84-0.53) in FL (n = 21), indicative of bone gain in FL (p = 0.003), the latter due to a difference at baseline but bone-level was comparable (p = 0.126). Groups were comparable for probing pocket depth (PPD); (3.32 vs. 3.19 mm), Bleeding Index (BI); (0.15 vs. 0.22), and gingival recession; (0.38 vs. 0.17 mm). According to international criteria, the peri-implantitis incidence was 0%, but 32.5% of the implants/crowns experienced biological or technical complications irrespective of surgical technique. Solitary implants and crowns show good long-term clinical outcomes and peri-implant health. Flapless surgery is a good alternative to conventional in straightforward cases with sufficient bone volume and proper treatment planning.

Maxillary Full Arch Restorations – Biological Complications: A Narrative Review Outlining Criteria for Long Term Success

Patients receiving full arch implant borne maxillary prostheses require functional, esthetic, and long term success. The importance of this review is to document the difficulty with implant maintenance, the prevalence of peri-implant disease, and the improvement in biologic health when using a prosthesis that can be maintained to minimize plaque. The objective is to provide surgeons with a reference to optimize surgical procedures that can result in improved hygiene and long term maintenance, as well as acceptable functional and esthetic goals. Pubmed.gov was the information source. Years reviewed included 1990-2022. Inclusion criteria included only articles in journals referenced in pubmed.gov. The reports excluded were case reports, reports that only included implant survival, and articles without a statistical analysis to generate meaningful conclusions. Biological complications included bone loss, hygiene difficulty, mucositis and recession, the incidence of peri-implantitis, and how complications related to patient co-morbidities. Data collected included outcomes of the study including statistical significance. The search identified articles for review using terms which included full arch maxillary restorations (n=736), long term success with full arch maxillary prostheses (n=22), ceramic full arch restorations (n=102), and complications with full arch restorations (n=231). From this search, 53 articles were collated that satisfied the inclusion criteria. Factors found to be significant contributors to biological complications included bone loss and peri-implant disease, difficulty with daily hygiene access, plaque and biofilm coverage, and the need for continued maintenance for long term implant health. The surgeon needs to place implants to allow a full arch maxillary prosthesis to be fabricated with full access to the implants for maintenance, which should decrease the incidence of biological complications. With excellent maintenance full arch implant restorations can have limited peri-implant disease.

Clinical Outcomes of Metal-Ceramic versus Metal-Acrylic Resin Implant-Supported Fixed Complete Dental Prostheses: A Systematic Review and Meta-analysis.

To compare the clinical outcomes of metal-ceramic vs metal-acrylic resin implant-supported fixed complete denture prostheses (IFCDPs). An electronic literature database search was conducted in the CINAHL, EMBASE, PubMed, and Web of Science databases. Additionally, a manual search of the literature was performed. Studies conducted in edentulous human subjects comparing clinical outcomes of metal-acrylic resin IFCDPs to those of metal-ceramic IFCDPs were included if quantitative outcomes for the following variables were reported: implant failure, prosthetic failure, incidence of peri-implantitis, incidence of peri-implant mucositis, incidence of peri-implant mucosal recession, prosthetic complications, and any patient-centered outcomes. Data from included studies were pooled to estimate effect size. Five studies met the inclusion criteria. A quantitative analysis was possible for risk of implant failure, prosthesis failure, and incidence of peri-implantitis. Meta-analysis showed no statistically significant differences in the risk of implant or prosthesis failure between the two groups. However, meta-analysis showed a significantly greater risk of developing peri-implantitis at the implant level in the metal-acrylic group when compared to the metal-ceramic group (risk difference = 0.069; 95% CI = 0.028 to 0.06; P = .001; fixed-effects model). Furthermore, descriptive analysis of the literature indicated a higher incidence of other biologic complications such as peri-implant mucositis and peri-implant mucosal recession, as well as prosthetic complications such as abrasion and veneer fracture, in metal-acrylic resin IFCDPs compared to metal-ceramic IFCDPs. The available evidence suggests that a higher incidence of biologic and prosthetic complications, including a higher risk of peri-implantitis, are present with metal-acrylic resin IFCDPs compared to metal-ceramic IFCDPs.

COIR-Dec-22-RVA-9809.R2 - The influence of smoking on the incidence of peri-implantitis: A systematic review and meta-analysis.

The aim of this study is to systematically analyze the influence of smoking on the incidence of peri-implantitis. The search was performed in the National Library of Medicine (MEDLINE-PubMed), SCOPUS, EMBASE, and ISI Web of Science databases (finished on November 30th , 2022). Systematic review and meta-analysis were conducted according to PRISMA statement. Prospective cohort studies that evaluate the incidence of peri-implantitis in smokers and non-smokers were included. Two authors independently searched for eligible studies, screened titles, and abstracts, did the full-text analysis, extracted data, and performed the risk-of-bias assessment. The results were summarized through random effects meta-analyses. The GRADE method was used to determine the certainty of evidence. A total of 7 studies with 702 patients and 1959 implants were included for analysis. The meta-analysis revealed a significant difference between smokers and non-smokers for the risk of peri-implantitis in the implant-based (p < 0.0001) and patient-based analysis (p=0.003). A strong association between smoking and the risk for peri-implantitis was verified at the implant level (RR: 2.04, 95% CI: 1.46-1.85) and the patient level (RR: 2.79, 95% CI: 1.42-5.50). Moderate certainty evidence suggests that smoking is associated with peri-implantitis compared to non-smoking at the patient and implant levels.

Peri-implantitis after 40 years: Evidence, mechanisms, and implications: A mapping review

Statement of problemThe high prevalence of peri-implantitis (PI) continues to plague patients and the disease is resistant to present treatment regimens. An analysis of the available research is lacking. PurposeGiven the abundance and diversity of research on the topic of PI, the purpose of this mapping review was to synthesize the literature on the prevention of PI, the histopathology of the disease, the state of present therapeutics, and any emerging treatments. Material and methodsAn extensive literature search was undertaken by using the electronic databases of PubMed, Web of Science, and Science Direct. The keyword strings were peri-implantitis, dental implant, risk assessment, histopathology, prosthesis design, and treatment. The filters applied were time interval from 2000 to 2002; language, English. ResultsA total of 3635 articles were taken from PubMed, 3686 articles from Web of Science, and 2450 articles from Science Direct. After applying the inclusion and exclusion criteria to the titles and abstracts of selected investigations, 214 studies were retrieved. ConclusionsThe evidence reflects a concerning incidence of PI, without a predictable treatment protocol. An in-depth patient risk assessment considering risk modification, emphasis on surgical and restorative expertise, and strict recall and maintenance is essential to minimize PI.

Research progress of local sustained-release drug delivery system in the treatment of peri-implantitis

With the increasing demand for oral implants, the incidence of peri-implantitis is also increasing year by year, and serious cases may even lead to implant loss. Studies have shown that the clinical treatment of peri-implantitis is divided into resection and regenerative surgery, and conventional drug treatment is divided into systemic and local administration. Compared with systemic administration, the local sustained-release system can not only reduce the adverse reactions and drug resistance of systemic administration, but also achieve a high concentration of drugs that can continuously kill bacteria in the periodontal pocket. Therefore, the treatment of peri-implantitis with local sustained-release system has become a research hotspot at home and abroad. This article reviews the research progress of local sustained-release system in the treatment of peri-implantitis in recent years.

Clinical evaluation and patient related outcomes of one- and two-piece zirconia implants at five years of loading: A case series study.

The objective of this study was to investigate the survival and biological and mechanical complications of one-piece and two-piece zirconia implants at five years of loading. Consecutive patients receiving zirconia implants were studied, collecting data at five years of loading on their clinical history, peri-implant health status, mechanical complications, esthetic results, and patient related outcomes. The study included 18 patients with 29 implants. The survival rate was 86% in implant-based analysis and 78% in patient-based analysis. There were no cases of peri-implantitis, but mucositis was present in 53% of implants. A mean of 4.1 ± 0.81 mm was obtained for probing depth and 1.6 ± 0.9 mm for crestal bone loss (radiographic assessment). There were no implant fractures. Major (10%) and minor (10%) prosthesis complications were observed. The esthetic outcome was moderate to almost perfect, with a high level of patient satisfaction. No significant association was found between survival rate and the presence of mucositis around one- or two-piece implants or any other study variable. The survival rate is low for one- and two-piece zirconia implants. Both types of implants demonstrated a low mechanical complication rate. The incidence of periimplantitis is low but mucositis is present in 50%. Patient satisfaction related to esthetics and function is moderate to high. They represent a good option for patients requiring an alternative to titanium implants. Zirconia implants appear to be an alternative to the titanium option and may be indicated for patients requiring "metal-free" restorations.

Metabolic Conditions and Peri-Implantitis.

Dental implants to replace lost teeth are a common dentistry practice nowadays. Titanium dental implants display a high success rate and improved safety profile. Nevertheless, there is an increasing peri-implantitis (PI), an inflammatory disease associated with polymicrobial infection that adversely affects the hard and soft tissues around the implant. The present review highlights the contribution of different metabolic conditions to PI. The considerations of both local and systemic metabolic conditions are crucial for planning successful dental implant procedures and during the treatment course of PI. Un- or undertreated PI can lead to permanent jaw bone suffering and dental implant losses. The common mediators of PI are inflammation and oxidative stress, which are also the key mediators of most systemic metabolic disorders. Chronic periodontitis, low-grade tissue inflammation, and increased oxidative stress raise the incidence of PI and the underlying systemic metabolic conditions, such as obesity, diabetes mellitus, or harmful lifestyle factors (cigarette smoking, etc.). Using dental biomaterials with antimicrobial effects could partly solve the problem of pathogenic microbial contamination and local inflammation. With local dentistry considering factors, including oral microbiota and implant quality control, the inclusion of the underlying systemic metabolic conditions into the pre-procedure planning and during the treatment course should improve the chances of successful outcomes.

Can Peri-Implant Marginal Bone Loss Progression and a-MMP-8 Be Considered Indicators of the Subsequent Onset of Peri-Implantitis? A 5-Year Study.

The aim of this retrospective study was to investigate the relationship between the amount of early bone remodeling, the marginal bone loss (MBL) progression, and the peri-implant sulcular fluid concentration of active metalloproteinase-8 (a-MMP-8) and the incidence of peri-implantitis (P) over 5 years of implant function. It has been documented that dental implants with a high degree of early marginal bone loss (MBL) are likely to achieve additional increased MBL during function. Moreover, it has been speculated that early increased MBL might be a predictive factor for the subsequent onset of peri-implant inflammatory diseases. Clinical and radiographic data at implant placement (T0) and restoration delivery (TR) at 6 months (T1), 2 years (T2), and 5 years (T5) post-loading were retrospectively collected. MBL levels/rates (MBLr) and peri-implant sulcular fluid levels/rates of a-MMP-8 were assessed at TR, T1, T2, and T5. Implants were divided into two groups: group 1 with peri-implantitis (P+) and group 2 without peri-implantitis (P-). A multi-level simple binary logistic regression, using generalized estimation equations (GEEs), was implemented to assess the association between each independent variable and P+. A receiver operating characteristics (ROC) curve was used to evaluate an optimal cutoff point for T1 MBL degree and a-MMP-8 level to discriminate between P+ and P- implants. A total of 80 patients who had received 80 implants between them (39 implants with a laser-microtextured collar surface (LMS) and 41 implants with a machined collar surface (MS)) were included. Periapical radiographs and a software package were used to measure MBL rates. Peri-implant sulcular implant fluid samples were analyzed by a chairside mouth-rinse test (ImplantSafe®) in combination with a digital reader (ORALyzer®). Twenty-four implants (six with an LMS and eighteen with an MS) were classified as P+. No statistically significant association was found between the amount of early bone remodeling, MBL progression, and MBLr and the incidence of peri-implantitis. Implants with a-MMP-8 levels &gt;15.3 ng/mL at T1 presented a significantly higher probability of P+. The amount of early marginal bone remodeling cannot be considered as an indicator of the subsequent onset of P, whereas high a-MMP-8 levels 6 months after loading could have a distinct ability to predict P.

Is the degree of physiological bone remodeling a predictive factor for peri-implantitis?

The amount of initial physiological bone remodeling (IPBR) after implant placement varies and the ways it may play a role in peri-implantitis development remains unknown. The aim of this retrospective study was to investigate the association between the amount of IPBR during the first year of implant placement and incidence of peri-implantitis as well as the pattern of progressive bone loss. Clinical and radiographic documentation of implants at the time of implant placement (T0), 1 year ± 6 months after crown placement (T1), and at a ≥2-year follow-up from implant placement (T2) were retrospectively collected. IPBR was defined as the bone loss occurring from implant placement to the end of the bone remodeling (T1). Cases were grouped into those diagnosed with (test) or without peri-implantitis (PIm) (control). Linear regression model under generalized estimation equation approach was estimated to assess correlation between marginal bone loss (MBL) rates in both periods (T1-T0) and (T2-T1). Receiver operating characteristics curve was estimated to explore an optimal cut-off point of T1-T0 MBL to discriminate between PIm and no-PIm implants. A total of 45 patients receiving 57 implants without PIm and 40 with PIm were included. There were no associations between PIm and IPBR (p&gt;0.05), nor between BML of (T2-T1) and (T1-T0). However, arch and total follow-up showed significant influence on the probability of PIm. Splinted implants showed an MBL rate of 0.60-mm/year higher than non-splinted implants (p&lt;0.001) from T1 to T2. No statistically significant association was found between IPBR and incidence of peri-implantitis.

Case Series on the Long-Term Effect of Three Different Types of Maxillary Implant-Supported Overdentures on Clinical Outcomes and Complications.

(1) Long-term data on maxillary implant overdentures (IODs) are scarce. This case series evaluated three types of IODs supported by six, four or three implants (Anyridge®, Mega’Gen Implant Co., Ltd., Daegu, South-Korea), after 3–5 years in function. (2) A total of 31 patients, with 132 implants, were non-randomly allocated based on available bone or financial limitations. IOD-6 received a telescopic overdenture; IOD-4 a bar; and IOD-3, non-connected implants with locator abutments. Implant survival, bone level changes, probing pocket depth (PPD), plaque index, bleeding on probing (BOP), and technical, biological and aesthetic complications were registered. Impact of suprastructures on bone loss and PPD was analyzed using mixed-effect linear regression models. Differences between groups were analyzed using the ANOVA test for BOP, and Kruskal Wallis test for complications. (3) In total, 23 patients participated in the follow-up (9 female, 14 male), with average age of 62.2 years; 7, 11 and 5 patients in IOD-6, IOD-4 and IOD-3, respectively. Implant survival after 4.4 years on average, was 98% in total; 100%, 97.8% and 93.3% for IOD-6, IOD-4 and IOD-3, respectively. Mean bone loss corresponded to 0.68 mm (SD 1.06, range −4.57–1.51), 0.39 mm (SD 1.06, range −3.6–2.43), and 1.42 mm (SD 1.68, range −5.11–0.74) for IOD-6, IOD-4 and IOD-3, respectively. A statistically significant difference was seen in bone level when comparing IOD-6 to IOD-3 (p = 0.044), and IOD-4 to IOD-3 (p = 0.018). Mean PPD was 3.8 mm (SD: 0.69; range 2.5–5.3), 3.5 mm (SD 0.59; range 2.33–5), and 3.2 mm (SD 0.56; range 2–4) for IOD-6, IOD-4 and IOD-3, respectively, and differed significantly between IOD-6 and IOD-3 (p = 0.029). Incidence of peri-implantitis was 1%. No differences were seen for complications between groups. (4) Maxillary IOD supported by four to six implants is the most reliable treatment regarding implant survival and peri-implant health. More research is needed in the clinical outcomes, in particular the peri-implant health, and complications of maxillary IODs, especially with a reduced number of implants.

Incidence of Peri-Implantitis and Relationship with Different Conditions: A Retrospective Study.

Articles on the prevalence of peri-implant diseases showed that 90% of peri-implant tissues had some form of inflammatory response and a prevalence of peri-implantitis from 28% to 51% according to various publications. Objective: To provide an overview of how risk factors can be related with peri-implantitis. Methods: A retrospective longitudinal study including 555 implants placed in 132 patients was evaluated based on the presence of peri-implantitis following the criteria of Renvert et al. 2018. Results: In total, 21 patients (15.9%) suffered peri-implantitis (PPG) and 111 patients (84.1%) did not suffer peri-implantitis (NPG). The results reveal that smokers have a high incidence of peri-implantitis (72.7%) compared to non-smokers (27.3%) (p < 0.0005). Another variable with significant results (p < 0.01) was periodontitis: 50% PPG and 23.9% NPG suffered advanced periodontitis. Systemic diseases such as arterial hypertension, diabetes mellitus, osteoporosis, and cardiovascular diseases do not show a statistically significant influence on the incidence of peri-implantitis. Patients who did not attend their maintenance therapy appointment had an incidence of peri-implantitis of 61.4%, compared to 27.3% in those who attend (p < 0.0001). From the results obtained, we can conclude that relevant factors affect peri-implantitis, such as tobacco habits, moderate and severe periodontitis, and attendance in maintenance therapy.

What is the influence of implant surface characteristics and/or implant material on the incidence and progression of peri-implantitis? A systematic literature review.

To answer the focused question, 'In animals or patients with dental implants, does implant surface characteristics and/or implant material have an effect on incidence and progression of peri-implantitis?' Pre-clinical in vivo experiments on experimental peri-implantitis and clinical trials with any aim and design, and ≥5years follow-up, where the effect of ≥2 different type of implant material and/or surface characteristics on peri-implantitis incidence or severity, and/or progression, implant survival or losses due to peri-implantitis, and/or marginal bone levels/loss was assessed. Meta-analyses based on data of pre-clinical experiments, using the ligature induced peri-implantitis model in the dog, indicated that after the spontaneous progression phase implants with a modified surface showed significantly greater radiographic bone loss (effect size 0.44mm; 95%CI 0.10-0.79; p=.012; 8 publications) and area of infiltrated connective tissue (effect size 0.75mm2 ; 95%CI 0.15-1.34; p=.014; 5 publications) compared to non-modified surfaces. However, in 9 out of the 18 included experiments, reported in 25 publications, no significant differences were shown among the different implant surface types assessed. Clinical and/or radiographic data from 7605 patients with 26,188 implants, reported in 31 publications (20 RCTs, 3 CTs, 4 prospective cohort, and 4 retrospective studies; 12 with follow-up ≥10years), overall did not show significant differences in the incidence of peri-implantitis, when this was reported or could be inferred, among the various implant surfaces. In general, high survival rates (90-100%) up to 30years and no clinically relevant differences in marginal bone loss/levels, merely compatible with crestal remodelling, were presented for the various implant types. Pre-clinical in vivo experiments indicate that surface characteristics of modified implants may have a significant negative impact on peri-implantitis progression, while clinical studies do not support the notion that there is a difference in peri-implantitis incidence among the various types of implant surfaces. No assumptions can be made regarding the possible impact of implant material on incidence and/or peri-implantitis progression due to limited information.

Long term clinical performance of 10 871 dental implants with up to 22 years of follow-up: A cohort study in 4247 patients.

BackgroundThe present retrospective study was aimed to assess the long‐term clinical performance of dental implants in a cohort study of 4247 patients.MethodsA longitudinal observational cohort study was done on all implants performed by a single periodontist from July 1995 to April 2019. The main outcome variables of this study were implant failure and marginal bone level around implants.ResultsThe study participants received a total of 10 871 implants with a mean of 2.56 implants per patient. The cohort was followed‐up to 22.2 years (mean = 4.5 ± 4.2). Among the 4247 patients of the current study, 140 patients (3.3%) experienced a combined total of 178 implant failures. According to life table analysis, at the implant level the cumulative survival rate at 3, 5, 10, and 15 years was 98.9%, 98.5%, 96.8%, and 94.0%, respectively while at patient level was 97.4%, 96.7%, 92.5%, and 86% at 3, 5, 10, and 15 years. Patients with multiple units were at a greater risk for having an implant failure. Baseline bone level was 0.09 ± 0.28 mm while at 8–10 years the mean bone level was 0.49 ± 0.74 mm. The incidence of peri‐implant mucositis at the implant level was 9.4% at 2–3 years, 9.3% at 4–5 years, 12.1% at 6–7 years, and 11.9% at 8–10 years. The incidence of peri‐implantitis was 2%, 2.6%, 3.2%, and 7.1% at 2–3, 4–5, 6–7, and 8–10 years, respectively. Cigarette smoking and diabetes mellitus were positively correlated with implant failure.ConclusionsThough the results are promising and encouraging in terms of survival and bone level over time, it is important to emphasize the potential risk factors and consider them prior to dental implant placement.