Analysis of risk indicators for prevalence of peri-implant diseases in Turkish population

Prevalence and risk factors of peri-implant diseases at patient-level: A cross-sectional study in Syria

OBJECTIVES

This research aims to assess the prevalence of peri-implant diseases and to analyze variables of the probable risk at the patient level associated with the occurrence of peri-implant diseases in Syrian patients.

MATERIALS AND METHODS

A cross-sectional study has been carried out on 142 patients with 380 dental implants placed between 2015 and 2021. Patients were invited by phone to return to Damascus University's Periodontology Department for clinical and radiological examination. A descriptive statistical analysis was implemented for the prevalence of peri-implant diseases at the level of the patients. Also, the peri-implant diseases' factors of risk were determined by the multivariate analytical model.

RESULTS

The prevalence rate of peri-implant mucositis and peri-implantitis in patients was 58.5% and 25.4%, respectively. Peri-implant disease is associated with multivariate risk indices, gender female (peri-implant mucositis [OR = 0.269; 95% CI: 0.131-0.552] and peri-implantitis [OR = 0.561; 95% CI: 0.561-0.216]), diabetes (peri-implant mucositis [OR = 3.4; 95% CI: 1.73-12.73]), periodontitis (peri-implant mucositis [OR = 2.409; 95% CI: 1.760-2.613], peri-implantitis [OR = 10.445; 95% CI: 4.097-26.629]).

CONCLUSIONS

Peri-implant diseases are common in the Syrian community. Several patient-level variables (gender female, diabetes, and periodontitis) are associated with peri-implant disease.

The lack of keratinized mucosa as a risk factor for peri-implantitis: a systematic review and meta-analysis

This study aimed to investigate the effect of the lack of keratinized mucosa on the risk of peri-implantitis, while also accounting for possible confounding factors. A literature search was conducted in PubMed and Scopus, including human studies that assessed the presence and width of keratinized mucosa in relation to the occurrence of peri-implantitis. Twenty-two articles were included, and 16 cross-sectional studies we meta-analyzed. The prevalence of peri-implantitis was 6.68-62.3% on patient-level and 4.5-58.1% on implant-level. The overall analysis indicated that the lack of keratinized mucosa was associated with a higher prevalence of peri-implantitis (OR = 2.78, 95% CI 2.07-3.74, p < 0.00001). Similar results were shown when subgroup analyses were performed, including studies with a similar case definition of peri-implantitis (Marginal Bone Loss, MBL ≥ 2 mm) (OR = 1.96, 95% CI 1.41-2.73, p < 0.0001), fixed prostheses only (OR = 2.82, 95% CI 1.85-4.28, p < 0.00001), patients under regular implant maintenance (OR = 2.08, 95% CI 1.41-3.08, p = 0.0002), and studies adjusting for other variables (OR = 3.68, 95% CI 2.32-5.82, p = 0.007). Thus, the lack of keratinized mucosa is a risk factor that increases the prevalence of peri-implantitis and should be accounted for when placing dental implants.

Association between cumulative smoking exposure, span since smoking cessation, and peri-implantitis: a cross-sectional study

OBJECTIVES

To investigate the association of cumulative smoking exposure and span since smoking cessation with the occurrence of peri-implantitis.

METHODS

A sample of 350 individuals aged ≥ 35 years, with the presence of at least one osseointegrated implant functioning for > 5 years, were enrolled in the study. According to smoking habits, participants were categorized into 3 groups: non-smokers (NS; n = 212), former smokers (FC; n = 66), and current smokers (CS; n = 72). Complete peri-implant and periodontal examinations were evaluated. Associations between the occurrence of peri-implantitis and smoking habits, as well as potential confounders, were evaluated through univariate and multivariate analyses.

RESULTS

The occurrence of peri-implantitis in the NS, FS, and CS groups was 18.2%, 19.7%, and 30.5%, respectively. A high prevalence of the overall number of cases with periodontitis (54.2%) was observed in the CS group when compared to the FS and NS groups. After adjusting for confounders, the odds ratio (OR) for the occurrence of peri-implantitis was 2.63 (1.39-6.77; p < 0.001) for CS compared to NS. There was a significant dose-response relationship between pack/year of smoking and the occurrence of peri-implantitis, as well as a significant decrease in the risk as the years of smoking cessation increased.

CONCLUSIONS

The occurrence of peri-implantitis among CS was high. The cumulative smoking exposure in an incremental manner and the shorter smoking cessation span was directly associated with a higher risk for peri-implantitis.

CLINICAL RELEVANCE

Educational and preventive strategies in general health services must attempt to reduce the adverse effects of cumulative smoking exposure and to explore the beneficial effects of smoking cessation on peri-implant status.

Influence of Periodontitis, Implant, and Prosthesis Characteristics on the Peri-Implant Status: A Cross-Sectional Study

Background

The association between peri-implant diseases and the periodontal, implant, and prosthesis characteristics has been characterized in various ways.

Purpose

The aim of this study was to evaluate the link between the peri-implant and periodontal status and the influence of implant and prosthesis parameters during implant follow-up.

Materials and Methods

One hundred and seven patients with a total of 310 implants that had at least one year of function who were attending periodontal and implant maintenance at a university clinic setting were included in this cross-sectional study. The demographic, periodontal, peri-implant tissue, implant, and prosthesis parameters were recorded. A pocket depth > 4 mm with bleeding on probing defined periodontal/peri-implant soft tissue diseased sites. Analyses were performed at the patient and implant levels using univariable and multivariable mixed regression analysis.

Results

The mean implant follow-up was 7.22 years. At the patient level, the bleeding on probing and pocket depth measurements were more pronounced around the implant than around the teeth. The opposite was observed for plaque and the clinical attachment levels. At the implant level, multivariable analysis showed that the periodontal and corresponding peri-implant tissue parameters, such as diseased sites, were closely related. The implant location, bone level, and number were selectively associated with the implant bone level, while cemented retention and emergence restoration profile influenced the implant pocket depth.

Conclusions

The present study suggested that clinical peri-implant and periodontal soft tissue statuses were different, which could be a consequence of the initial implant and prosthesis healing process. However, during implant follow-up, the peri-implant parameters were predominantly associated with their corresponding periodontal parameters regardless of an association with the implant and prosthesis characteristics. This trial is registered with ClinicalTrials.gov ID: NCT03841656.

The Crucial Role of Plaque Control in Peri-Implant Mucositis Initiation as Opposed to the Role of Systemic Health Condition: A Cross-Sectional Study

Purpose

The aim of this study was to investigate the priority of periodontal plaque as a risk factor compared to other risk factors, namely hypertension and diabetes mellitus type II, regarding the initiation and severity of peri-implant mucositis, eventually reinforcing the importance of plaque control, periodic maintenance and supportive periodontic treatment after implant placement in order to prevent peri-implant diseases.

Patients and Methods

A total of 58 patients (84 implants) were enrolled; each individual implant was considered as a separate sample first, then sampling by patient was also applied, implants were divided into group A: systemically healthy patients and B: patients with hypertension and diabetes mellitus type II, the status of peri-implant tissue was followed after the healing abutment placement, with regard to implant mucosal index (IMI), probing pocket depth (PPD) and bleeding on probing (BOP); when sampling was done by patient, the mean of scores of all examined implants in each patient was taken to represent one sample.

Results

Group A implants showed higher mean scores of PPD (5.2 mm) than group B (4.2 mm) with significance (P = 0.014), and higher mean scores of BOP, group A = 0.71, group B = 0.45 with (P = 0.015); there was no statistical difference with regard to IMI, group A = 1.35, group B = 1.16 with (P = 0.172). Similar results were obtained when the sampling was calculated by patient; PPD: group A (5.31 mm), group B (4.75 mm) and P = 0.008, IMI: group A (1.34), group B (1.16) and P = 0.131, BOP: group A (0.75), group B (0.48) and P = 0.03.

Conclusion

In the absence of proper plaque control, systemic diseases showed no impact on the initiation and severity of peri-implant mucositis when compared to systemically healthy patients.

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Evaluation of clinical performance and survival rate of Straumann dental implants in Saudi Population based on cross-sectional study

Risk indicators of peri-implantitis is still contradictory and somehow unclear in present literature therefore efforts should be done for better understanding of the exact etiology of peri-implant disease progression. The present study aimed to assess risk indicators associated with peri-implantitis by observing the changes in several periodontal parameters after implant placement. This cross-sectional study included 213 female and 271 male patients aged 26–87 years, who received 484 titanium implants (Straumann, Switzerland) at King Saud University’s Dental College, Saudi Arabia. Patients were called for dental visits. During these visits; full clinical and radiographic assessment of implants were done. The periodontal pocket depth (PPD) was greater around implants placed at grafted sites than non-grafted sites and around bone-level implants than tissue-level implants. The plaque index (PI) was associated with poor oral hygiene. There was a strong association between graft (yes/no) and bleeding on probing (BOP). Patients with good oral hygiene showed high radiographic bone stability. Keratinized tissue width < 2 mm was associated with a higher PPD, higher PI, higher BOP, more edematous gingiva, and more exposed implant threads on radiography. In patients receiving implants, poor oral hygiene status and inadequate keratinized tissue level can be proposed as risk indicators for developing periimplantitis due to strong association found between them and developments of peri-implantitis.

Association between periodontitis treatment outcomes and peri-implantitis: A long-term retrospective cohort study

OBJECTIVES

Retrospectively evaluate the association of periodontal treatment outcomes and the prevalence of peri-implant diseases around tissue-level implants.

MATERIALS AND METHODS

Eighty-six patients with 260 tissue-level implants attending supporting periodontal and implant therapy for more than 3 years were evaluated. Clinical and radiographic periodontal and implant data were recorded at initial examination (T0), before implant placement (T1) and at final re-examination (T2). Two definitions of peri-implantitis severity, PIBE and PIKA, were used corresponding to the presence of periodontal pocket ≥5 mm or ≥6 mm with bleeding on probing or suppuration and radiographic signs of a bone level ≥2 mm, or ≥3 mm during implant follow-up, respectively. Analyses were performed at patient level.

RESULTS

The mean implant follow-up per patient was 9.4 years and 38.0% of patients had implant for at least 10 years. Two implants were lost due to peri-implantitis. The prevalence of patients with PIKA and PIBE was 15.1% and 12.8%, respectively. Residual periodontal pockets, clinical attachment loss and bone loss/age at T2 were more pronounced in patients with PIKA and PIBE. Cox regression analysis adjusted with the number of implants per patient showed that residual pockets at T1 were independently associated with PIKA and PIBE. Initial diagnosis of severe periodontitis was associated with PIBE incidence.

CONCLUSIONS

The present study showed that periodontal conditions before implant placement are a risk indicator for peri-implantitis incidence. During implant follow-up, the severity of periodontal status appeared to be a reliable indicator of patient susceptibility to peri-implantitis.