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Perussolo J, Donos N. Maintenance of peri-implant health in general dental practice. Br Dent J 2024; 236:781-789. [PMID: 38789755 PMCID: PMC11126374 DOI: 10.1038/s41415-024-7406-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/19/2024] [Accepted: 04/22/2024] [Indexed: 05/26/2024]
Abstract
The long-term maintenance or restoration of peri-implant tissues' health depends on the strategic implementation of preventive measures and interventions. These measures should be initiated before implant placement and continued throughout a patient's lifetime, as part of a tailored and comprehensive supportive peri-implant care (SPIC) programme. Central to the clinical efforts of maintaining and rehabilitating peri-implant tissues are several key factors, including the ongoing assessment and frequent monitoring of tissue health and stability, proactive oral health promotion, the control of risk factors and indicators and the provision of professional plaque biofilm removal. It is of paramount importance to underline that SPIC should not limit its scope exclusively to patients already in a state of peri-implant health; in fact, it is imperative that it should extend its protective effect to individuals who have been previously diagnosed and treated for peri-implant diseases, focusing on preventing its recurrence and progression, thereby avoiding further complications, such as implant loss.This narrative review presents an overview of the current literature on the maintenance of peri-implant tissues' health and the steps of SPIC providing insights into the critical factors to be considered when managing dental implant patients in the general dental practice.
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Affiliation(s)
- Jeniffer Perussolo
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, Turner Street, London, E1 2AD, UK
| | - Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, Turner Street, London, E1 2AD, UK.
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West N, Chapple I, Culshaw S, Donos N, Needleman I, Suvan J, Nibali L, Patel A, Preshaw PM, Kebschull M. BSP Implementation of prevention and treatment of peri-implant diseases - The EFP S3 level clinical practice guideline. J Dent 2024; 149:104980. [PMID: 38697506 DOI: 10.1016/j.jdent.2024.104980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 03/28/2024] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVES to adapt the supranational European Federation of Periodontology (EFP) Prevention and Treatment of Peri-implant Diseases - The EFP S3 Level Clinical Practice Guideline for UK healthcare environment, taking into account a broad range of views from stakeholders and patients. SOURCES This UK version, based on the supranational EFP guideline [1] published in the Journal of Clinical Periodontology, was developed using S3-level methodology, combining assessment of formal evidence from 13 systematic reviews with a moderated consensus process of a representative group of stakeholders, and accounts for health equality, environmental factors and clinical effectiveness. It encompasses 55 clinical recommendations for the Prevention and Treatment of Peri-implant Diseases, based on the classification for periodontal and peri‑implant diseases and conditions [2]. METHODOLOGY The UK version was developed from the source guideline using a formal process called the GRADE ADOLOPMENT framework. This framework allows for adoption (unmodified acceptance), adaptation (acceptance with modifications) and the de novo development of clinical recommendations. Using this framework, following the S3-process, the underlying evidence was updated and a representative guideline group of 111 delegates from 26 stakeholder organisations was assembled into four working groups. Following the formal S3-process, all clinical recommendations were formally assessed for their applicability to the UK and adoloped accordingly. RESULTS AND CONCLUSION Using the ADOLOPMENT protocol, a UK version of the EFP S3-level clinical practice guideline for the Prevention and Treatment of Peri-implant Diseases was developed. This guideline delivers evidence- and consensus-based clinical recommendations of direct relevance to the UK healthcare community including the public. CLINICAL SIGNIFICANCE The S3-level-guidelines combine evaluation of formal evidence, grading of recommendations and synthesis with clinical expertise of a broad range of stakeholders. The international S3-level-guideline was implemented for direct clinical applicability in the UK healthcare system, facilitating a consistent, interdisciplinary, evidence-based approach with public involvement for the prevention and treatment of peri‑implant diseases.
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Affiliation(s)
- Nicola West
- Restorative Dentistry, Bristol Dental School, University of Bristol, Bristol BS1 2LY, UK; Restorative Dentistry, Bristol Dental Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Marlborough Street, Bristol BS1 3NU, UK; Secretary General, European Federation of Periodontology, 4 rue de la Presse, 1000, Brussels, Belgium.
| | - Iain Chapple
- Birmingham NIHR Biomedical Research Centre in Inflammation. The University of Birmingham, Birmingham, UK; Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK
| | - Shauna Culshaw
- University of Glasgow Dental School, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Nikos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London (AMUL), Turner Street, London, E1 2AD, UK
| | - Ian Needleman
- Unit of Periodontology, UCL Eastman Dental Institute, Bloomsbury Campus, Rockefeller Building, 21 University Street, London, WC1E 6DE, UK
| | - Jeanie Suvan
- Unit of Periodontology, UCL Eastman Dental Institute, Bloomsbury Campus, Rockefeller Building, 21 University Street, London, WC1E 6DE, UK
| | - Luigi Nibali
- Periodontology Unit, Centre for Host-Microbiome Interactions, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, Guys Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Amit Patel
- Birmingham Dental Specialists, President of the Association of Dental Implantology, University of Birmingham, Birmingham, UK
| | - Philip M Preshaw
- School of Dentistry, University of Dundee, Dundee UK; School of Dental Sciences, University of Newcastle, Newcastle upon Tyne, UK
| | - Moritz Kebschull
- Birmingham NIHR Biomedical Research Centre in Inflammation. The University of Birmingham, Birmingham, UK; Birmingham Community Healthcare NHS Foundation Trust, Birmingham, UK; Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA; School of Dentistry, University of Birmingham, President-Elect of the European Federation of Periodontology, Birmingham B5 7EG, UK.
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Guney Z, Altingoz SM, Has H, Serdar MA, Kurgan S. The impact of electronic cigarettes on peri-implant health: A systematic review and meta-analysis. J Dent 2024; 143:104883. [PMID: 38360396 DOI: 10.1016/j.jdent.2024.104883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/05/2024] [Accepted: 02/06/2024] [Indexed: 02/17/2024] Open
Abstract
OBJECTIVES Recent literature suggests that the use of electronic cigarette (e-cigarette) is a substantial contributing factor to the unsuccessful outcomes of dental implant procedures. Our aim was to systematically review the effect of e-cigarette use on clinical (PI, PD, BOP), radiographic (bone loss), and immunologic (IL-1β) peri‑implant parameters. DATA Main search terms used in combination: electronic cigarette, peri‑implantitis, vaping. SOURCES An electronic search was undertaken for MEDLINE, EMBASE, COCHRANE, and SCOPUS databases between 2017 and 2023. STUDY SELECTION The study protocol was developed according to PRISMA guidelines, and the focus question was formulated according to the PICO strategy. No restriction was accepted regarding language or year to avoid selection bias; the initial database search yielded 49 publications. Following the selection process, only seven studies met the inclusion criteria. Seven studies were statistically analyzed via MedCalc program. A pooled effect was deemed statistically significant if the p-value was less than 0.05. CONCLUSION Electronic cigarettes cause an increase in probing depth, bone loss, and the level of IL-1β, one of the bone destruction mediators in the tissues around the implant, and a decrease in bleeding on probing. CLINICAL SIGNIFICANCE E-cigarette is a potential risk factor for the healing process and the results of implant treatment, similar to cigarettes. Performing clinical research to evaluate the e-cigarette effect on peri‑implantitis in an age and gender-match population is needed.
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Affiliation(s)
- Zeliha Guney
- Department of Periodontology, Faculty of Dentistry, Ankara Medipol University, Ankara, Turkey
| | - S Merve Altingoz
- Department of Periodontology, Faculty of Dentistry, Lokman Hekim University, Ankara, Turkey
| | - Hande Has
- Graduate School of Health Sciences, Ankara University, Ankara, Turkey
| | - Muhittin A Serdar
- Department of Medical Biochemistry, School of Medicine, Acibadem University, İstanbul, Turkey
| | - Sivge Kurgan
- Department of Periodontology, Faculty of Dentistry, Ankara University, Ankara, Turkey.
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Majid OW. Dose- and time-dependent association of smoking and its cessation with risk of peri-implant diseases. Evid Based Dent 2024; 25:15-16. [PMID: 38036652 DOI: 10.1038/s41432-023-00957-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 11/17/2023] [Indexed: 12/02/2023]
Abstract
DESIGN A retrospective cohort study involved patients who received at least one implant-supported restoration at a university dental clinic between 2001 and 2013. Patients were randomly selected from an electronic database, and their recruitment via telephone contact spanned from February 2021 until July 2021. MAIN OBJECTIVE To investigate the association of smoking and its cessation with the risk of peri-implant mucositis and peri-implantitis in a cohort of implant-treated patients. METHODS The study adhered to the principles outlined in the Declaration of Helsinki and followed the STROBE guidelines for reporting observational research. Included were adult patients who were rehabilitated with dental implants, irrespective of the type of edentulism, superstructure, and prosthetic retention, provided that they had adequate access for peri-implant probing. Patients with incomplete records were excluded. Clinical measurements included plaque and bleeding indices, periodontal pocket depth, suppuration on probing, mucosal recession, and width of keratinized mucosa. Periapical radiographs were taken and marginal bone level (MBL) was measured using ImageJ software. The primary outcome variable was peri-implant status which was classified into: health (H), peri-implant mucositis (PM), and peri-implantitis (PI). Smoking status was categorized into: never-smokers, former smokers, and current smokers. Smoking information included: daily cigarette consumption, duration of smoking (in years), and age at initiation, and for former smokers, the duration of smoking cessation. RESULTS The cohort included 117 patients (55 females and 62 males) with a mean age of 64.2 years at examination. They were rehabilitated by 450 implants, with an average of 4.6 implants per patient and a mean duration of 8 years in function. Out of the total, 39 patients were H, while 41 and 37 showed PM and PI, respectively. Periodontal and MBL measures were significantly higher in PM and PI groups compared to H group (p < 0.001). Considering tobacco use, 56 patients were never-smokers, 42 former smokers, and 19 current smokers. The average daily consumption of cigarettes was 15.7. Ever-smokers >23 pack-years had a significantly higher risk for PI (OR = 3.40; 95% CI 0.91-17.30; p = 0.002) compared to nonsmokers. Regression analysis showed that subjects with a span since smoking cessation of more than 21 years exhibited a significantly lower risk of peri-implant diseases (PIDs) than those who had ceased smoking within 21 years (p = 0.028). CONCLUSION A smoking intensity exceeding 23 pack-years was significantly associated with PI risk, while the risk of PIDs was comparable between never-smokers and those who had quit smoking more than 21 years ago.
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Affiliation(s)
- Omer Waleed Majid
- Department of Oral and Maxillofacial Surgery, College of Dentistry, Mosul University, Mosul, Iraq.
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Insua A, Galindo-Moreno P, Miron RJ, Wang HL, Monje A. Emerging factors affecting peri-implant bone metabolism. Periodontol 2000 2024; 94:27-78. [PMID: 37904311 DOI: 10.1111/prd.12532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/05/2023] [Accepted: 09/10/2023] [Indexed: 11/01/2023]
Abstract
Implant dentistry has evolved to the point that standard implant osseointegration is predictable. This is attributed in part to the advancements in material sciences that have led toward improvements in implant surface technology and characteristics. Nonetheless, there remain several cases where implant therapy fails (specifically at early time points), most commonly attributed to factors affecting bone metabolism. Among these patients, smokers are known to have impaired bone metabolism and thus be subject to higher risks of early implant failure and/or late complications related to the stability of the peri-implant bone and mucosal tissues. Notably, however, emerging data have unveiled other critical factors affecting osseointegration, namely, those related to the metabolism of bone tissues. The aim of this review is to shed light on the effects of implant-related factors, like implant surface or titanium particle release; surgical-related factors, like osseodensification or implanted biomaterials; various drugs, like selective serotonin reuptake inhibitors, proton pump inhibitors, anti-hypertensives, nonsteroidal anti-inflammatory medication, and statins, and host-related factors, like smoking, diet, and metabolic syndrome on bone metabolism, and aseptic peri-implant bone loss. Despite the infectious nature of peri-implant biological complications, these factors must be surveyed for the effective prevention and management of peri-implantitis.
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Affiliation(s)
- Angel Insua
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Pablo Galindo-Moreno
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Oral Surgery and Implant Dentistry, University of Granada, Granada, Spain
| | - Richard J Miron
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Hom-Lay Wang
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, University of Bern, Bern, Switzerland
- Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain
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Guabello G, Zuffetti F, Ravidà A, Deflorian M, Carta G, Saleh MHA, Serroni M, Pommer B, Watzek G, Francetti L, Testori T. Avoiding implant-related complications in medically compromised patients with or without unhealthy lifestyle/Elevated oxidative stress. Periodontol 2000 2023; 92:329-349. [PMID: 37350348 DOI: 10.1111/prd.12503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/11/2023] [Accepted: 04/26/2023] [Indexed: 06/24/2023]
Abstract
Increased human life expectancy broadens the alternatives for missing teeth and played a role in the widespread use of dental implants and related augmentation procedures for the aging population. Though, many of these patients may have one or more diseases. These systemic conditions may directly lead to surgical complications, compromise implant/bone healing, or influence long-term peri-implant health and its response to biologic nuisances. Offering patients credible expectations regarding intra- and postoperative complications and therapeutic prognosis is an ethical and legal obligation. Clear identification of potential types of adverse effects, complications, or errors is important for decision-making processes as they may be related to different local, systemic, and technical aspects. Therefore, the present review structures the underlying biological mechanisms, clinical evidence, and clinical recommendations for the most common systemic risk factors for implant-related complications.
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Affiliation(s)
- Gregorio Guabello
- Endocrinology Unit, IRCCS Galeazzi Sant'Ambrogio Hospital, Milan, Italy
| | - Francesco Zuffetti
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
| | - Andrea Ravidà
- Department of Periodontics and Preventive Dentistry, University of Pittsburgh School of Dental Medicine, Pittsburgh, Pennsylvania, USA
| | - Matteo Deflorian
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
| | - Giorgio Carta
- Argo Academy International Research Bologna, Bologna, Italy
- Private Practice, Bologna, Italy
- Lake Como Institute, Como, Italy
| | - Muhammad H A Saleh
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Matteo Serroni
- Department of Innovative Technologies in Medicine & Dentistry, University 'G. D'Annunzio', Chieti-Pescara, Italy
| | - Bernhard Pommer
- Academy for Oral Implantology, Vienna, Austria
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Luca Francetti
- IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
| | - Tiziano Testori
- Section of Implant Dentistry and Oral Rehabilitation, IRCCS Galeazzi Sant'Ambrogio Hospital, Dental Clinic, Milan, Italy
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, Massachusetts, USA
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Sadowsky SJ. Peri-implantitis after 40 years: Evidence, mechanisms, and implications: A mapping review. J Prosthet Dent 2023:S0022-3913(23)00114-2. [PMID: 36935269 DOI: 10.1016/j.prosdent.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 03/19/2023]
Abstract
STATEMENT OF PROBLEM The 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. PURPOSE Given 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 METHODS An 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. RESULTS A 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. CONCLUSIONS The 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.
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Affiliation(s)
- Steven J Sadowsky
- Professor, Preventive and Restorative Department, University of the Pacific Arthur A. Dugoni School of Dentistry, San Francisco, Calif.
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Carra MC, Blanc-Sylvestre N, Courtet A, Bouchard P. Primordial and primary prevention of peri-implant diseases: A systematic review and meta-analysis. J Clin Periodontol 2023. [PMID: 36807599 DOI: 10.1111/jcpe.13790] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/21/2023]
Abstract
AIM This systematic review and meta-analysis aims to assess the efficacy of risk factor control to prevent the occurrence of peri-implant diseases (PIDs) in adult patients awaiting dental implant rehabilitation (primordial prevention) or in patients with dental implants surrounded by healthy peri-implant tissues (primary prevention). MATERIALS AND METHODS A literature search was performed without any time limit on different databases up to August 2022. Interventional and observational studies with at least 6 months of follow-up were considered. The occurrence of peri-implant mucositis and/or peri-implantitis was the primary outcome. Pooled data analyses were performed using random effect models according to the type of risk factor and outcome. RESULTS Overall, 48 studies were selected. None assessed the efficacy of primordial preventive interventions for PIDs. Indirect evidence on the primary prevention of PID indicated that diabetic patients with dental implants and good glycaemic control have a significantly lower risk of peri-implantitis (odds ratio [OR] = 0.16; 95% confidence interval [CI]: 0.03-0.96; I2 : 0%), and lower marginal bone level (MBL) changes (OR = -0.36 mm; 95% CI: -0.65 to -0.07; I2 : 95%) compared to diabetic patients with poor glycaemic control. Patients attending supportive periodontal/peri-implant care (SPC) regularly have a lower risk of overall PIDs (OR = 0.42; 95% CI: 0.24-0.75; I2 : 57%) and peri-implantitis compared to irregular attendees. The risk of dental implant failure (OR = 3.76; 95% CI: 1.50-9.45; I2 : 0%) appears to be greater under irregular or no SPC than regular SPC. Implants sites with augmented peri-implant keratinized mucosa (PIKM) show lower peri-implant inflammation (SMD = -1.18; 95% CI: -1.85 to -0.51; I2 : 69%) and lower MBL changes (MD = -0.25; 95% CI: -0.45 to -0.05; I2 : 62%) compared to dental implants with PIKM deficiency. Studies on smoking cessation and oral hygiene behaviors were inconclusive. CONCLUSIONS Within the limitations of available evidence, the present findings indicate that in patients with diabetes, glycaemic control should be promoted to avoid peri-implantitis development. The primary prevention of peri-implantitis should involve regular SPC. PIKM augmentation procedures, where a PIKM deficiency exists, may favour the control of peri-implant inflammation and the stability of MBL. Further studies are needed to assess the impact of smoking cessation and oral hygiene behaviours, as well as the implementation of standardized primordial and primary prevention protocols for PIDs.
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Affiliation(s)
- Maria Clotilde Carra
- U.F.R. d'Odontologie, Université Paris Cité, Paris, France.,Service of Odontology, Periodontal and Oral Surgery Unit, Rothschild Hospital (AP-HP), Paris, France.,Population-Based Epidemiologic Cohorts Unit, Inserm, UMS 11, Villejuif, France
| | - Nicolas Blanc-Sylvestre
- U.F.R. d'Odontologie, Université Paris Cité, Paris, France.,Service of Odontology, Periodontal and Oral Surgery Unit, Rothschild Hospital (AP-HP), Paris, France.,URP 2496, Université Paris Cité, Paris, France
| | - Alexandre Courtet
- U.F.R. d'Odontologie, Université Paris Cité, Paris, France.,Service of Odontology, Periodontal and Oral Surgery Unit, Rothschild Hospital (AP-HP), Paris, France
| | - Philippe Bouchard
- U.F.R. d'Odontologie, Université Paris Cité, Paris, France.,URP 2496, Université Paris Cité, Paris, France
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Monje A, Kan JY, Borgnakke W. Impact of local predisposing/precipitating factors and systemic drivers on peri‐implant diseases. Clin Implant Dent Relat Res 2022. [PMID: 36533411 DOI: 10.1111/cid.13155] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 11/01/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Strong evidence suggests the infectious nature of peri-implant diseases occurring in susceptible hosts. Epidemiological reports, though, indicate that peri-implantitis is a site-specific entity. Hence, the significance of local factors that may predispose/precipitate plaque accumulation and the impact of systemic drivers that alter the immune response are relevant in the prevention and management of peri-implant disorders. PURPOSE The purpose of the present review is to shed light on the significance of local and systemic factors on peri-implant diseases, making special emphasis on the associations with peri-implantitis. METHODS The biologic plausibility and supporting evidence aiming at providing a concluding remark were explored in the recent scientific literature for local predisposing/precipitating factors and systemic drivers related to peri-implant diseases. RESULTS Local predisposing factors such as soft tissue characteristics, implant position and prosthetic design proved being strongly associated with the occurrence of peri-implant diseases. Hard tissue characteristics, however, failed to demonstrate having a direct association with peri-implant diseases. Robust data points toward the strong link between residual sub-mucosal cement and peri-implant diseases, while limited data suggests the impact of residual sub-mucosal floss and peri-implantitis. Systemic drivers/habits such as hyperglycemia and smoking showed a strong negative impact on peri-implantitis. However, there is insufficient evidence to claim for any link between metabolic syndrome, atherosclerotic cardiovascular disease, and obesity and peri-implant diseases. CONCLUSION Local predisposing/precipitating factors and systemic drivers may increase the risk of peri-implant diseases. Therefore, comprehensive anamnesis of the patients, educational/motivational programs and exhaustive prosthetically-driven treatment planning must be fostered aiming at reducing the rate of biological complications in implant dentistry.
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Affiliation(s)
- Alberto Monje
- Department of Periodontology and Oral Medicine University of Michigan Ann Arbor Michigan USA
- Department of Periodontology Universitat Internacional de Catalunya Barcelona Spain
- Department of Periodontology, ZMK University of Bern Bern CH Switzerland
| | - Joseph Y. Kan
- Department of Implantology Loma Linda University Loma Linda California USA
| | - Wenche Borgnakke
- Department of Periodontology and Oral Medicine University of Michigan Ann Arbor Michigan USA
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