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Associations between clinical parameters assessed around implants and teeth
Authors:Urs Brägger  Walter B Bürgin  Christoph H F Hämmerle  Niklaus P Lang
Institution:University of Berne, School of Dental Medicine, Clinic for Periodontology and Fixed Prosthodontics, Berne, Switzerland
Abstract:The aim of the present study was to clinically assess the peri-implant and periodontal conditions 1 year after placement of oral implants (ITI® Dental Implant System) in partially edentulous patients. In all, 127 patients (median age 50 years, range 17 to 79) were examined. They were all treated according to a concept of comprehensive dental care and had received fixed partial dentures (FPD). Significant differences were observed between implants and contralateral control teeth with respect to mean pocket probing depth (PPD)(2.55 mm at implants/2.02 mm at teeth), mean probing attachment level (PAL)(2.97 mm/253 mm) and bleeding on probing (BOP)(24%/12%)(Wilcoxon matched pairs sign rank test, P≥0.0l), whereas mean modified plaque index (0.22/0.30), mean modified bleeding index (0.351 0.44) and mean recession (?0.42 mm/?0.51mm) did not significantly differ between implants and teeth. Compared to control teeth, the width of keratinized mucosa at implants was significantly smaller at lingual, but not at buccal aspects. Regression analyses showed no significant association between the amount of keratinized mucosa and degree of inflammation. Recession, PPD and PAL were slightly influenced by the amount of keratinized mucosa indicating greater resistance to probing. Grouping the implants according to various lengths, type of fixation of the FPD or combination with natural teeth did not result in statistically significant different clinical parameters, whereas grouping according to different localization within the oral cavity did. For example, the mean PAL in 83 anterior implants was 2.52mm, whereas 175 posterior implants had a mean PAL of 3.18mm (Mann-Whitney U-test, P≤0.01). Regression analyses between the mean PAL for all implants in each patient and the mean PAL of the corresponding dentition revealed an r² of 0.23 (P≤0.01). Using multiple regression analysis, the mean PAL of the implants showed to be significantly influenced by the combined factors “fullmouth” PII, “fullmouth” BOP and mean PAL of all teeth. The resuhs of this study suggest that in partially edentulous patients the overall periodontal condition may influence the clinical condition around implants and thus reinforces the importance of periodontal treatment prior to and supportive periodontal therapy after the incorporation of osseointegrated oral implants.
Keywords:periodontal disease  peri‐implantitis  dental implants  gingiva  peri‐implant mucosa  fixed partial dentures  single crowns
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