Although there was a greater reduction in the number of sites with BOP following treatment with the Vector system than following instrumentation with carbon fiber curettes, there was no significant difference between the two methods.

Implants placed in patients with a history of periodontitis have a 5-year survival similar to that observed for implants installed in non-diseased persons. Although the 10-year survival of the one-stage implants was somewhat lower than has been observed for non-diseased patients, implant placement remains a good treatment alternative also for periodontally compromised patients.

The present study evaluate the outcome of implant therapy in periodontally compromised patients in need of additional functional tooth support. A total of 31 Astra implants and 93 ITI Dental Implant System implants were inserted in 19 and 56 patients, respectively. The length of the implants varied between 8 and 14 mm, with 45% being 8 mm and 21% being 11 mm or more. Most implants were placed in the maxilla, predominantly in the premolar region, while less than 25% were placed in the mandible. The observation period ranged between 12 and 40 months for Astra implants and between 3 and 84 months for ITI implants. At annual recall visits, 4 sites on all implants were assessed for presence of plaque, bleeding on probing, probing depth, and radiographic assessment of bone loss was performed. A total of 3 implants, all ITI implants, failed, yielding a 3-year survival rate of 95-100%, depending on type of implant. After 3 years, 76-86% of all implants remained free from radiographic bone loss > or = 1.5 mm. After 5 years, 55% of the ITI implants remained free from such bone loss. These results indicate that periodontally compromised patients, who have experienced a considerable loss of alveolar bony support, can be successfully treated with implants.

This study reports the results of implant therapy involving a sinus membrane lift as well as conventional implant therapy in 24 periodontally compromised patients who were treated during the period between June 1990 and May 1995. Patients were included on the basis of being in need of at least 2 implants, 1 of which was to be placed in the maxillary sinus region, and at least 3 mm bone height was required in the sinus region. Following fenestration of the lateral sinus wall and lifting of the sinus membrane sinus implants were inserted as described for conventional implants. Annual follow-up visits included recording of plaque, probing pocket depth and bleeding on probing, and recording of the radiographic distance from the implant shoulder to the alveolar crest in mm. The Astra, Astra sinus, ITI, and ITI sinus were observed for an average of 30.8, 29.9, 29.4 and 25.3 months, respectively. Of the 80 implants inserted 1 Astra and 2 ITI had failed at 11-12 months and 1 ITI had failed at 42 months. The Kaplan-Meier estimate of the proportion of non-failed implants at 36 months were 100%, 95%, 91%, and 86% for the Astra, Astra sinus, ITI, and ITI sinus implants, respectively. Of the Astra, Astra sinus, and ITI implants, 71-82% remained free from bone-loss > or = 1.5 mm at 36 months, whereas this was the case for only 29% of the ITI sinus implants. About 80-90% of the implants remained free from plaque; 65-86% remained free from bleeding; and 44-80% remained free from pockets > or = 4 mm. These results indicate that the sinus lift technique can be used successfully in periodontally compromised patients.

This study reports the results of implant therapy involving a sinus membrane lift and of conventional implant therapy in 68 periodontally compromised patients treated between June 1990 and June 2002. Patients had at least two implants inserted, one of which was placed in the maxillary sinus region following fenestration of the lateral sinus wall and lifting of the sinus membrane. Two implant systems were used: a two-stage system (Astra) and a one-stage system (ITI). Annual follow-up visits included recording of plaque, probing pocket depth and measurement of the radiographic distance in millimeter from the implant shoulder to the alveolar crest. Survival analysis showed that the proportion of implants that had not been explanted after 5 years ranged between 88.7% for ITI sinus implants and 97% for ASTRA conventional implants. After 10 years, the proportion of implants remaining in situ ranged between 59% for ITI conventional implants and 97% for ASTRA conventional implants. Cox regression analyses showed that the factors influential for implant explantation were implant type (HR(ITI) = 2.8), implant length (HR(< or = 10 mm) = 3.1), patient being a smoker (HR(smoking) = 2.2) and patient having at least 20 natural teeth (HR(> or = 20 teeth) = 3.8). Our results demonstrate that sinus implants may be inserted with the same success as conventional implants in periodontally compromised patients.