Risk Factors For Peri-implant Diseases Research Articles

Stabilized oral lichen planus does not compromise dental implants survival: A systematic review and meta-analysis.

This study aimed to evaluate the incidence of implant failure in patients with oral lichen planus (OLP) and investigate the potential association between OLP and peri-implant diseases. Embase, Web of Science, PubMed, and Scopus databases were searched for studies with no time restrictions. Meta-analysis was performed calculating pooled proportion of peri-implantitis (PI), peri-implant mucositis (PIM), and bleeding on probing (BOP) prevalence using fixed-effects model. Odds ratio and corresponding 95% CI were calculated to assess the potential risk of PI, PIM, and BOP in dental implant patients with OLP compared to healthy controls. Implant failure rate was 4.38% at the patient level and 4.37% at the implant level. Six patients (3.92%) from five studies were diagnosed with oral cancer after receiving implant. The prevalence of PI, PIM, and BOP at the implant level were 14.00%, 20.00%, and 40.00%, respectively. There was no significant difference in the occurrence of PI and PIM between OLP patients and healthy controls. Stabilized OLP is not considered a significant risk factor for peri-implant diseases. It is advised against placing implants or prostheses during the acute phase of the disease. Histopathological investigation to differentiate OLP from oral lichenoid dysplasia is crucial.

Patient-, implant- and prosthetic-related factors on peri-implant mucositis and bone loss.

Peri-implant diseases, including peri-implant mucositis (PIM) and peri-implantitis, are a chronic inflammatory disorder triggered by bacterial biofilm in susceptible hosts. Potential risk factors for peri-implant diseases include smoking, dental plaque accumulation, poor oral hygiene, genetics, and absence of peri-implant keratinized mucosa. This cohort study aimed to evaluate the influence of patient-, implant-, and prosthetic-related factors on PIM and peri-implant bone loss (PBL) around dental implants after 1 year of loading. A total of 54 subjects (22 males and 32 females) were included in the study. Peri-implant clinical parameters were assessed and standardized periapical radiographs of each dental implant were obtained 15 days after the definitive prosthesis installation (baseline) and at 3, 6, and 12 months of follow-up. A total of 173 implants were evaluated. PIM affected 44.8% of the implants and no significant association was found between the investigated parameters and PIM incidence, except for type of implant connection. A significantly higher incidence of PIM (80.0%) was observed for implants with internal hexagon connection type after 1 year of follow-up (p = 0.015). Moreover, a mean PBL of 0.35 ± 1.89 mm was observed and no dental implant was affected by peri-implantitis after 1 year of function. No specific influence of patient, implant, or prosthetic factors on PBL was observed. No association was found between the occurrence of PIM/PBL and the patient-, implant-, and prosthetic-related factors investigated in this cohort study, except for the type of dental-implant connection.

Smoking by altering the peri-implant microbial community structure compromises the responsiveness to treatment.

Smoking is an essential risk factor for peri-implant diseases. It also hampers the clinical outcomes of peri-implant therapies. Nonetheless, the effect of smoking can go undetected until the emergence of clinical signs. Bacterial-induced inflammation is responsible for the initiation and progression of peri-implant diseases. We hypothesize that smoking impacts the peri-implant microbiome even in status of clinical health, putting it into a sub-healthy condition that responds poorly to peri-implant treatments. To validate this, peri-implant plaque samples from 18 participants including 10 smokers (S) and 8 non-smokers (NS), who had received implant prostheses were analyzed using metagenomic shotgun sequencing. The results showed that in addition to taxonomical and functional differences, the local stability in the S group was also shown to be much higher than that in the NS group, indicating greater stubbornness of the peri-implant microbiome associated with smoking. Besides, the topological structures were also distinct between the two groups. The highly connected species interacted more preferentially with each other in the S group (eigenvector centralization, 0.0273 in S and 0.0183 in NS), resulting in a greater tendency of forming small-world modules (modularity, 0.714 in S and 0.582 in NS). While in the NS group, inter-species correlations were more evenly distributed (clustering coefficient, 0.532 in S and 0.666 in NS). These alterations overall explained the greater stubbornness of the peri-implant microbiome associated with smoking, which may cause poor responsiveness to peri-implant therapies. From a microbial perspective, this may be a potential reason why smoking impacts negatively on the outcome of peri-implant treatments.

Evaluation of Risk Factors of Peri-Implant Disease Using a New Manual Risk Assessment Model: A Clinical study.

Background Implants are being widely used as a treatment option and are considered the best line of treatment owing to their high level of predictability. However, over 5 years, 0–14.4% of dental implants have demonstrated peri-inflammatory reactions associated with loss of crestal bone and ultimately loss of the implant. Peri-implant diseases are categorized into peri-implant mucositis and peri-implantitis. There are a number of risk factors associated with these conditions, and the early detection of these possible risk factors, change in the treatment protocol whenever required along with a regular follow-up, can ensure a better survival rate of dental implants. In the present study, an attempt has been made to evaluate the risk factors associated with peri-implant diseases and also to correlate these risk factors to the prevalence of peri-implant diseases using the formulated risk assessment model. Methodology. The risk assessment model was prepared based on existing literature explaining the risk factors for peri-implant diseases. This study was conducted as a pilot study, and the method of complete sampling was used wherein all subjects in whom implants have been placed at the Department of Periodontology and Department of Prosthodontics were recalled and assessed. The model was then evaluated on patients in whom dental implants were placed and the implants were loaded for a year. A total of 13 subjects with 21 implants were assessed for the presence or absence of risk factors, and a score was given. Test of proportion and chi-square test was done. Results and Discussion. Of the 21 implants assessed, 15 implants were found to be at low risk and 6 implants with moderate risk of peri-implant disease. The number of implants with low risk was higher in implants with peri-implant mucositis (25%) whereas the implants with moderate risk was higher in implants with peri-implantitis (75%). This comparison was statistically significant with a p value of 0.022. Conclusion This risk assessment tool can be used in the early detection of peri-implant disease, and identifying the risk factor may help in the success rate of the implant survival.

THE ASSOCIATION BETWEEN DENTAL IMPLANTS REHABILITATION AND PATIENTS WITH ORAL LICHEN PLANUS: AN INTEGRATIVE REVIEW

Objectives The aim of this critical literature review was to investigate the evidence and reports regarding patients diagnosed with oral lichen planus (OLP) and rehabilitated with dental implants (DI). Study Design This integrative literature review was prepared in accordance with the PRISMA statement and based on the proposed focused question. Specific descriptors were organized according to the PICO strategy, and a literature search was performed for PubMed, Web of Science, and Embase databases. Results The literature demonstrated limited findings about the association between OLP and DI. The studies showed that DI placement is not contraindicated for patients with OLP, and specific surgical guidelines were not found. The DI placement was avoided when patients showed recurrence or acute phases of OLP. In addition, OLP is not as a considerable risk factor for peri-implant diseases even with poor oral hygiene. The approach of short dental implant placement with the objective to reduce the number of complex surgical interventions was indicated. The maintenance care and rigorous follow-up of implant-prosthetic rehabilitation of patients with OLP is fundamental for implant survival rates, which showed a mean of 95.3%. Conclusions Patients with OLP disorder can be rehabilitated with dental implants. The aim of this critical literature review was to investigate the evidence and reports regarding patients diagnosed with oral lichen planus (OLP) and rehabilitated with dental implants (DI). This integrative literature review was prepared in accordance with the PRISMA statement and based on the proposed focused question. Specific descriptors were organized according to the PICO strategy, and a literature search was performed for PubMed, Web of Science, and Embase databases. The literature demonstrated limited findings about the association between OLP and DI. The studies showed that DI placement is not contraindicated for patients with OLP, and specific surgical guidelines were not found. The DI placement was avoided when patients showed recurrence or acute phases of OLP. In addition, OLP is not as a considerable risk factor for peri-implant diseases even with poor oral hygiene. The approach of short dental implant placement with the objective to reduce the number of complex surgical interventions was indicated. The maintenance care and rigorous follow-up of implant-prosthetic rehabilitation of patients with OLP is fundamental for implant survival rates, which showed a mean of 95.3%. Patients with OLP disorder can be rehabilitated with dental implants.

A Retrospective Analysis of Biological Complications of Dental Implants.

Methods A retrospective analysis of patients aged ≥18 years and having dental implants placed at Dubai Health Authority in 2010. Relevant information related to systemic-, patient-, implant-, site-, surgical- and prosthesis-related factors were collected. The strength of association between the prevalence of peri-implant mucositis and peri-implantitis and each variable was measured by chi-square analysis. A binary logistic regression analysis was performed to identify possible risk factors. Results A total of 162 patients with 301 implant-supported restorations were included in the study. The age of the patients ranged between 19 and 72 with a mean age of 46.4 ± 11.7 years. The prevalence of peri-implant mucositis at the patient and implant levels were 44.4% and 38.2%, respectively. For peri-implantitis, the prevalence at the patient level was 5.6%, while the prevalence at the implant level was 4.0%. The binary logistic regression identified three risk factors (smoking habits, histories of treated periodontitis and lack of peri-implant maintenance) for peri-implantitis. Conclusion Within the limitations of this study, smoking habits, history of treated periodontitis and lack of peri-implant maintenance were significant risk factors for peri-implantitis. Early detection of these factors would ensure appropriate planning and care of patients at high risk of developing peri-implant diseases.

Dental Implant Treatment in Patients Suffering from Oral Lichen Planus: A Narrative Review.

Background: The aim of this study was to describe the complications and survival rates of dental implants placed in patients suffering from oral lichen planus (OLP) and to present recommendations for implant treatment in this group of patients through a narrative review of the published studies. Methods: A search of the literature was conducted using four databases: PubMed/Medline, Web of Science, Cochrane, and Scopus with a stop date of May 2022. Results: Eighteen studies were evaluated. The results showed that dental implant survival rates in patients with OLP were similar to those reported in the general population. Moreover, the existing literature seemed to imply that OLP is not a suspected risk factor for peri-implant diseases. However, patients suffering from erosive forms of OLP or desquamative gingivitis and poor oral hygiene were more susceptible to developing peri-implant diseases; in addition, oral squamous cell carcinoma was observed in a few cases of OLP. Conclusion: With the limitations of this narrative review, dental implants may be regarded as a safe and feasible therapeutic approach to the treatment of patients with well-controlled OLP. These patients should be monitored carefully during follow-up care. Well-designed prospective trials are required to validate the present findings.

Identification of a Predictive Decision Model Using Different Data Mining Algorithms for Diagnosing Peri-implant Health and Disease: A Cross-Sectional Study.

The aim of this study was to determine a predictive decision model for peri-implant health and disease and to reveal the highest accuracy of prediction using three different data mining methods. This cross-sectional study included a total of 216 patients with 542 dental implants from the Periodontology Department of Gazi University. The implants were classified into peri-implant health, peri-implant mucositis, and peri-implantitis groups based on established clinical and radiographic assessments. Prediction models were created using clinical variables in combination with possible risk factors for peri-implant diseases. Different data mining methods (decision-tree [DT]; J48), logistic regression, and artificial neural network (multilayer perceptron [MLP]) were compared to yield a better predictive decision model based on predictor variables with the highest potential of effect. The prevalence of peri-implant mucositis and peri-implantitis among the participants of the specialist referral periodontal practice of the university was 36.1% (95% CI: 29.7 to 42.5) and 34.7% (95% CI: 28.4 to 41.0) at the patient level, respectively. The J48 method revealed a higher prediction of peri-implant health and disease with an accuracy of 0.871 compared with the logistic regression and MLP methods (0.832 and 0.852, respectively) for the present data set. In this specific patient population, the J48 model revealed the top-level node as "bleeding on probing (BOP)." "Maintenance therapy" and "medication use" were noted as powerful predictors in the next split-levels. The J48 model presented an acceptable predictive accuracy of peri-implant health and disease. The model revealed BOP as a major predictive clinical parameter when evaluated with possible risk factors for this patient population.

Clinical Decision Making for Primary Peri-Implantitis Prevention: Practical Applications.

When planning dental implant therapy, what risk-reduction strategies allow practitioners to select patients, sites, and restorative plans that decrease the incidence of peri-implant disease? With a marked increase in the number of patients receiving dental implants to treat partial or complete edentulism, it follows that the prevalence of peri-implant mucositis and peri-implantitis have increased. Risks associated with implant therapies may vary based upon underlying local, environmental, surgical, patient, prosthetic, and fixture-related factors. Furthermore, an emphasis on preventative measures and maintenance should be undertaken to avoid development and progression of peri-implant diseases. Thorough risk assessment, proper treatment planning, and early diagnosis and intervention are critical in the absence of definitive data of long-term success of treatments for peri-implant condition. Given the difficulty in intervention once peri-implantitis is established, identification of risk factors and development of treatment plans to address those factors before dental implant therapy is critical to the long-term health and success of dental implants. A patient-centered, evidence based approach to dental implant treatment planning to reduce the risk for peri-implantitis should be undertaken. Systematic diagnosis of disease state(s) and evaluation of the etiologic and modifying risk factors for peri-implant diseases can yield more optimal outcomes to reduce peri-implantitis rates.

Is oral lichen planus a risk factor for peri-implant diseases? A systematic review and meta-analysis

BackgroundTo evaluate whether oral lichen planus (OLP) is a risk factor for peri-implant diseases (PIDs) with a systematic review and meta-analysis.MethodsFive electronic databases including Medline, Embase, Web of Science, the Cochrane Library and Scopus were searched. The included studies are observational human studies written in English. The population of interest included those with/without OLP who received dental implant treatment. The follow-up time after implantation was from 1 month to 20 years. The quality of the included articles regarding risk of bias and methodology were assessed with the Newcastle-Ottawa Scale or the Agency for Healthcare Research and Quality. The data involving exposure (OLP), primary outcomes (implants having PIDs) and secondary outcomes (probing depth/PD, bleeding on probing/BOP and bone loss/BL) and potential confounders were extracted. Heterogeneity was assessed by I2 test. Dichotomous data are expressed as the risk ratio (RR) and 95% confidence interval (CI) which were calculated with a fixed effect model.ResultsOf the 66 articles, two studies were enrolled and evaluated as high quality, which totally contained 68 participants receiving 222 (OLP vs. non-OLP, 112 vs. 110) implants with 12 to 120-month follow-up time. Proportions of implants with PIDs between OLP and non-OLP groups were as follows: 19.6% (22/112) vs. 22.7% (25/110) for PIM and 17.0% (19/112) vs. 10.9% (12/110) for PI. The meta-analysis revealed no recognizable difference in number of implants with PIDs (PI: RR = 1.49, 95% CI 0.77–2.90, P = 0.24; PIM:RR = 0.88, 95% CI 0.53–1.46, P = 0.61; PIDs: RR = 1.08, 95% CI 0.75–1.55, P = 0.68) or BOP (RR = 0.90, 95% CI: 0.70–1.15, P = 0.40) between OLP and non-OLP groups.ConclusionsAvailable articles regarding the effects of OLP on PIDs remains very limited. Existing evidence does not support OLP as a suspected risk factor for PIDs. Large-scale prospective trials are required to validate the findings.

Tobacco-product usage as a risk factor for dental implants.

The oral cavities of tobacco smokers and users of smokeless tobacco products are exposed to high concentrations of nicotine. A limited number of animal studies have assessed the effect of nicotine on osseointegration. Results from experimental studies have reported a statistically significant decrease, at 4weeks of follow-up, in bone-to-implant contact among rats exposed to nicotine compared with unexposed rats. Nicotine increases the production of inflammatory cytokines (such as interleukin-6 and tumor necrosis factor-alpha) by osteoblasts. Waterpipe, pipe, and cigarette smokers are at increased risk of developing oral cancer, periodontal disease, and alveolar bone loss. One explanation for this is that smokers (regardless of the type of tobacco product) are exposed to similar chemicals, such as nicotine, tar, oxidants, polyaromatic hydrocarbons, and carbon monoxide. Moreover, raised levels of proinflammatory cytokines have been identified in the gingival crevicular fluid of cigarette smokers with peri-implant diseases. Therefore, it is hypothesized that nicotine and chemicals in tobacco smoke induce a state of oxidative stress in peri-implant tissues (gingiva and alveolar bone), thereby increasing the likelihood of peri-implant disease development via an inflammatory response, which if left uncontrolled, will result in implant failure/loss. In this regard, tobacco smoking (including cigarettes, waterpipe, and pipe) is a significant risk factor for peri-implant diseases. The impact of vaping electronic cigarettes using nicotine-containing e-juices remains unknown. Habitual use of smokeless tobacco products is associated with oral inflammatory conditions, such as oral precancer, cancer, and periodontal disease. However, the effect of habitual use of smokeless tobacco products on the success and survival of dental implants remains undocumented.

Prevalence and risk factors for peri-implant diseases in Japanese adult dental patients.

We investigated the prevalences and risk factors for peri-implant diseases in Japanese adult dental patients attending a follow-up visit at dental hospitals or clinics as part of their maintenance program. This cross-sectional multicenter study enrolled patients with dental implants who attended regular check-ups as part of a periodontal maintenance program during the period from October 2012 through September 2013. Patients with implants with at least 3 years of loading time were included in the study. The condition of peri-implant tissue was examined and classified into the following categories: healthy, peri-implant mucositis, and peri-implantitis. Patients were also evaluated for implant risk factors. A total of 267 patients (110 men, 157 women; mean age: 62.5 ± 10.7 years) were analyzed. The prevalence of patient-based peri-implant mucositis was 33.3% (n = 89), and the prevalence of peri-implantitis was 9.7% (n = 26). Poor oral hygiene and a history of periodontitis were strong risk factors for peri-implant disease. The present prevalences were lower than those previously reported. The quality of periodontal therapy before and after implant installation and patient compliance and motivation, as indicated by plaque control level, appear to be important in maintaining peri-implant tissue health.

Peri-Implantitis developing after placement of dental implant in a patient with a history of periodontitis and its treatment A Case Report

Recently, wide spreading use of dental implants in the prosthetic treatment of edentulous areas has increased the encountered possibility of peri-implant diseases. Peri-implantitis is an inflammatory process, including also bone loss in peri-implant tissues. Many local and systemic factors may play a role in its etiology. Patientrelated factors such as previously periodontitis history, diabetes, genetics, poor oral hygiene, smoking, alcohol consumption lack of keratinized soft tissue and the other factors such as selected implant system and type, surface properties of the implant, occlusal forces on implant and surrounding tissues, conditions encountered during the placement of implant are the possible risk factors for peri-implant diseases. Similar to periodontal diseases in the treatment of peri-implantitis, clinical and radiological diagnosis, non-surgical periodontal treatment, and also in addition to mechanical and chemical decontamination applications surgical periodontal treatment techniques such as flap operations, osteoplasty, ostectomy and guided bone regeneration has been usually applied. The aim of this case report is to present the clinical and radiographical diagnosis in conjunction with the regenerative treatment process of peri-implantitis observed five years after the placement of dental implants in a male patient with previously periodontitis history.

Clinical research on peri‐implant diseases: consensus report of Working Group 4

Two systematic reviews have evaluated the quality of research and reporting of observational studies investigating the prevalence of, the incidence of and the risk factors for peri-implant diseases and of experimental clinical studies evaluating the efficacy of preventive and therapeutic interventions. For the improvement of the quality of reporting for both observational and experimental studies, the STROBE and the Modified CONSORT recommendations were encouraged. To improve the quality of research in peri-implant diseases, the following were recommended: the use of unequivocal case definitions; the expression of outcomes at the subject rather than the implant level; the implementation of study validation tools; the reporting of potential sources of bias; and the use of appropriate statistical methods. In observational studies, case definitions for peri-implantitis were agreed. For risk factor determination, the progressive use of cross-sectional and case-control studies (univariate analyses), to prospective cohorts (multilevel modelling for confounding), and ultimately to intervention studies were recommended. For preventive and interventional studies of peri-implant disease management, parallel arm RCTs of at least 6-months were encouraged. For studies of non-surgical and surgical management of peri-implantitis, the use of a composite therapeutic end point was advocated. The development of standard control therapies was deemed essential.

Prevalence of Peri-implant Diseases Associated with a Rough-Surface Dental Implant System: 9 Years after Insertion

Introduction: The aim of this study was a retrospective clinical evaluation of the long-term prevalence of peri-implant diseases associated with a modern rough-surface dental implant system. Materials and methods: A total of 237 implants were inserted in 47 patients between 1994 and 2005. Peri-implant parameters (sulcus bleeding, pocket depth and bone loss) were evaluated at a mean of 9.1 years after insertion. Based on these parameters, cases were classified as healthy tissue, peri-implant mucositis and peri-implantitis. One-way analysis of variance was used to compare group parameters. Results: A total of 211 implants (89%) were healthy, 21 implants (9%) showed peri-implant mucositis and 5 (2%) showed peri-implantitis. Risk factors for peri-implant diseases were alcohol (p<0.001) and nicotine abuse (p<0.001) and irradiation (p<0.001). Conclusion: After a mean of 9.1 years, the TiOblast® dental implant showed a marginal rate of peri-implant disease. The calculated risk factors for development of peri-implant diseases are in accordance to previous studies.