Comparison of peri‐implant clinical and radiographic status around short (6 mm in length) dental implants placed in cigarette‐smokers and never‐smokers: Six‐year follow‐up results

Background

It is hypothesized that peri‐implant clinical and radiographic inflammatory parameters (probing depth [PD], bleeding on probing [BOP] and plaque index [PI]; and radiographic (crestal bone loss [CBL]) are worse among cigarette‐smokers (CS) compared with never‐smokers (NS) with short implants.

Purpose

The present 6‐year follow‐up retrospective study compared the peri‐implant clinical and radiographic parameters in CS and NS with short dental implants (6 mm in length).

Materials and methods

Fifty‐six male individuals were included. These individuals divided into 2 groups as follows: (a) Group‐1: 29 self‐reported systemically healthy CS with 48 short‐implants; and (b) Group‐2: 27 self‐reported systemically healthy NS with 43 short implants. Peri‐implant PD, PI, BOP, and CBL were measured. Group comparisons were done using the Kruskal‐Wallis test and sample size was estimated. Level of significance was set at P values < .05.

Results

In groups 1 and 2, the follow‐up durations were 6.2 ± 0.1 years and 6.1 ± 0.3 years, respectively. A cigarette smoking history of 8.9 ± 3.6 pack years was reported by individuals in Group‐1. At follow‐up, scores of peri‐implant PD, BOP, PI, and mesial and distal CBL were comparable around short implants in both groups.

Conclusion

Under strict oral hygiene maintenance protocols, short dental implants can remain functionally stable in CS in a manner similar to NS.     

Comparison of peri‐implant clinical and radiographic inflammatory parameters among cigarette and waterpipe (narghile) smokers and never‐smokers

1 Background

The authors hypothesized that peri‐implant clinical and radiographic inflammatory parameters are worse in waterpipe smokers (WS) and cigarette smokers (CS) compared with never‐smokers (NS). The aim of the present retrospective study is to compare peri‐implant clinical and radiographic inflammatory parameters among WS, CS, and NS.

2 Methods

Forty‐four CS (group 1), 41 WS (group 2), and 43 NS (group 3) were included. Demographic data were collected using a questionnaire. Peri‐implant plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were measured, and crestal bone loss (CBL) was assessed on standardized digital radiographs. Sample size was estimated, and statistical analyses were performed using Kruskal–Wallis and Wilcoxon rank‐sum tests. For multiple comparisons, Bonferroni post hoc test was performed. P values < 0.05 were considered statistically significant.

3 Results

Peri‐implant PI and PD were higher in groups 1 (P < 0.05) and 2 (P < 0.05) compared with group 3. Peri‐implant BOP was significantly higher in group 3 compared with individuals in groups 1 (P < 0.01) and 2 (P < 0.01). Peri‐implant total marginal bone loss was significantly higher in groups 1 (P < 0.05) and 2 (P < 0.05) compared with group 3. There were differences in PI, BOP, PD, and CBL among participants in groups 1 and 2.

4 Conclusions

Peri‐implant soft tissue inflammatory parameters and CBL are worse in CS and WS compared with NS. There is no difference in these parameters between CS and WS.     

Diagnostic accuracy of clinical parameters to monitor peri‐implant conditions: A matched case‐control study

1 Background

The aim of this case‐control study was to estimate the diagnostic accuracy of the standard clinical parameters in diagnosing healthy peri‐implant tissues, peri‐implant mucositis, and peri‐implantitis.

2 Methods

A case‐control study was designed to compare the clinical parameters used in the diagnosis of peri‐implant diseases such as: probingdepth (PD), bleeding on probing (BOP), mucosal redness (MR), suppuration (SUP), and plaque index (PI). Furthermore, the influence of patient‐ (sex, age) and implant‐related variables (implant neck configuration, time in function after loading) were evaluated to investigate the association with the clinical findings. The inferential analysis consisted of estimation by generalized estimating equations (GEE) of multilevel logistic regression models.

3 Results

In total, 1,572 sites were evaluated around 262 implants from 141 patients. Sites with implant mucositis showed significant levels of BOP (OR = 3.56), MR (OR = 7.66) and PD (OR = 1.48) compared to healthy sites. The specificity was 90.3% while the sensitivity was only 43.6%. Likewise, sites exhibiting peri‐implantitis showed significant levels of BOP (OR = 2.32), MR (OR = 7.21), PD (OR = 2.43) and SUP (OR = 6.81) compared to healthy sites. Again, the multiple logistic regressions showed high specificity (92.1%) but modest sensitivity (52.5%). PD was the only diagnostic marker displaying significance comparing peri‐implant mucositis and peri‐implantitis sites (OR = 1.76). Moreover, tissue‐level compared to bone‐level implants were less associated with SUP+ (OR = 0.20), and PI (OR = 0.36) and demonstrated statistical significance. In addition, age, sex, and function time significantly influenced the tested clinical parameters.

4 Conclusions

The diagnosis of peri‐implant diseases cannot rely solely upon individual clinical parameters but rather require a combination of criteria. The clinical parameters, particularly probing depth, might accurately discern between diagnoses among peri‐implant conditions. Nevertheless, the specificity of the clinical parameters surpasses the sensitivity in the detection of peri‐implant diseases, validating its potential use as a diagnostic tool.