Nine- to fourteen-year follow-up of implant treatment. Part III: factors associated with peri-implant lesions

OBJECTIVE: The aim of the present paper was to analyse, on patient and implant basis, factors related to peri-implant lesions. MATERIAL AND METHODS: Two hundred and eighteen patients treated with titanium implants were examined for biological complications at existing implants 9-14 years after initial therapy. The effects of several potentially explanatory variables, both on patient and on implant levels, were analysed. RESULTS: On the implant level, the presence of keratinized mucosa (p = 0.02) and plaque (p = 0.005) was associated with mucositis (probing depth > or =4 mm + bleeding on probing). The bone level at implants was associated with the presence of keratinized mucosa (p = 0.03) and the presence of pus (p < 0.001). On the patient level, smoking was associated with mucositis, bone level and peri-implantitis (p = 0.02, <0.001 and 0.002, respectively). Peri-implantitis was related to a previous history of periodontitis (p = 0.05). CONCLUSIONS: Individuals with a history of periodontitis and individuals who smoke are more likely to develop peri-implant lesions.     

Nine- to fourteen-year follow-up of implant treatment. Part I: implant loss and associations to various factors

Objectives: The aim of the present study was to evaluate the long‐term result of implant therapy, using implant loss as outcome variable. Material and Method: Two hundred and ninty‐four patients had received implant therapy (Brånemark System^®) during the years of 1988–1992 in Kristianstad County, Sweden. The patients were recalled to the speciality clinic 1 and 5 years after placement of the suprastructure. Between 2000 and 2002, 9–14 years after implant placements, the patients were again called in for a complete clinical and radiographic examination. Results: Two hundred and eighteen patients treated with 1057 implants were examined. Twenty‐two patients had lost 46 implants and 12 implants were considered “sleeping implants”. The overall survival rate was 95.7%. Implant loss appeared in a cluster in a few patients and early failures were most common. Eight patients lost more than one fixture. A significant relationship was observed between implant loss and periodontal bone loss of the remaining teeth at implant placement. Maxillary, as opposed to mandibulary implants, showed more implant loss if many implants were placed in the jaw. A significant relationship between smoking habits and implant loss was not found. Conclusion: A history of periodontitis seems to be related to implant loss.     

Definition and prevalence of peri-implant diseases

Objectives: The aim of the current review was to describe the prevalence of peri-implant diseases including peri-implant mucositis and peri-implantitis.
Material and Methods: A MEDLINE search (PubMed) until December 2007 was conducted and different keywords related to the prevalence of peri-implant diseases were used. Cross-sectional and longitudinal studies including 50 implant-treated subjects exhibiting a function time of 5 years were considered.
Results and Conclusion: The current review revealed that only a few studies provided data on the prevalence of peri-implant diseases. Cross-sectional studies on implant-treated subjects are rare and data from only two study samples were available. Peri-implant mucositis occurred in approximately 80% of the subjects and in 50% of the implants. Peri-implantitis was found in 28% and 56% of subjects and in 12% and 43% of implant sites.     

牙种植体周围微生物研究

牙种植术是目前修复牙列缺损和牙列缺失的主要治疗方案,但是种植体周围微生态失衡易造成种植体周围疾病的发生,进而导致种植失败。从20世纪80年代开始,种植体周围微生物的研究就成为了口腔微生物研究的热点之一。正常种植体周围微生物和种植体周围炎症相关微生物存在着差异,这些差异直接或间接增加了种植体周围疾病的风险,因此寻找种植体周围黏膜炎和种植体周围炎“核心微生物组”是目前研究的关键。     

种植体周围软组织厚度干预的临床研究

目的：对种植体周软组织厚度通过手术方式进行干预,观察该干预对种植体周健康状况的影响。方法：在种植义齿Ⅱ期手术过程中,对于软组织厚度〉5mm者行斜形切口;对于软组织厚度预期〈1.5mm者行结缔组织移植术。两者均调整软组织厚度至2.5～3mm,以对侧同名部位的种植牙为对照组,于种植体修复后半年,检测种植体周牙龈炎症指数（GI）、龈沟内金属基质蛋白酶-8（MMP-8）含量,以及种植体周骨丧失（BL）。结果：与对照组相比,斜形切口组MMP-8含量、BL均显著降低（P〈0.05）,结缔组织移植组GI、MMP-8、BL均无显著性变化。结论：适当的种植体周围软组织厚度处理有利于维护种植体周软组织的健康。     

Influence of alcohol and tobacco habits on peri-implant marginal bone loss: a prospective study

A prospective clinical study was conducted to explore the possible link between peri-implant bone loss and the widespread habits of tobacco smoking and alcohol consumption. One hundred and eighty-five patients who received 514 implants were followed up for 3 years. Peri-implant marginal bone loss was evaluated by digital panoramic radiography and image analysis techniques. Multivariate analysis showed that peri-implant marginal bone loss was significantly related to a daily consumption of >10 g of alcohol, tobacco use and increased plaque levels and gingival inflammation. The present results indicate that daily alcohol consumption and tobacco use may have a negative influence on predictable long-term implant treatment outcomes, producing peri-implant bone loss and compromising restorative treatment with implant-supported prostheses.     

Correlation of peri-implant health and myeloperoxidase levels: a cross-sectional clinical study

OBJECTIVES: At present, there are no diagnostic tools that permit early detection of peri-implantitis. The purpose of this cross-sectional study was to evaluate the correlation of myeloperoxidase (MPO) levels with traditional periodontal clinical parameters around dental implants including peri-implant pocket probing depth (PPD), gingival index (GI) and bleeding on probing (BOP), since MPO has been associated with destruction of periodontal tissues. MATERIAL AND METHODS: Twenty-four healthy adult volunteers (9 men and 15 women) with 64 Ankylos Biofunctional implants (DentsplyFriadent, Mannheim, Germany) were recruited from Tallinn Dental Clinic. Biochemical and clinical parameters evaluated were the following ones: the level of MPO in the peri-implant sulcus fluid (PISF) (an analog for gingival crevicular fluid in natural teeth), PPD (mm), GI (0,1,2 or 3), and BOP (0 or 1). RESULTS AND CONCLUSION: In comparison to the clinically healthy implants, total amounts of MPO were significantly higher in PISF collected around implants with inflammatory lesions. In addition, the levels of MPO were correlated with the clinical parameters. The results confirm the similarity of the inflammatory response of tissues surrounding implants and natural teeth, and suggest that MPO could be promising marker of inflammation around dental implants.     

Optical phenomenon of peri-implant soft tissue. Part II. Preferred implant neck color to improve soft tissue esthetics

OBJECTIVES: The purpose of this study was to investigate an optical solution to eliminate the undesirable shine-through effect of implants on peri-implant mucosa by selecting an optimized implant neck color based on an objective and quantifiable method. MATERIAL AND METHODS: The optical effect of color strips on 15 peri-implant mucosal sites of 14 patients with Straumann single-tooth implant replacements in the maxillary anterior region was analyzed. The color differences between the peri-implant mucosa with insertion of each of eight different color strips (white, black, light pink, pink, light orange, orange, gold, violet) and the gingiva of an adjacent or contralateral tooth without any color strips were compared for the selection of optimal color of implant neck. Spectrophotometric color measurements were performed to compare the color difference index (DeltaE) and color coordinates (DeltaL*, Deltaa*, Deltab* and DeltaC*). RESULTS: The colors of the peri-implant mucosa with color strips and the gingiva of natural tooth demonstrated that the test site soft tissue with color strips of light pink, pink, light orange and orange showed a significantly smaller DeltaE value (P<0.05). Moreover, light pink exhibited the lowest mean DeltaE value of 2.6+/-0.6, indicating a clinically indistinguishable color difference. CONCLUSIONS: The results suggest that it is possible to improve gingival esthetics by coloring the implant neck, most effectively with light pink, to mask the impact of the underlying titanium implant. The use of implants with optimized neck colors to correct an esthetic deficiency may be a feasible approach to establish improved peri-implant soft tissue esthetics.