AimTo evaluate the prevalence of peri‐implant diseases and to identify risk/protective indicators of peri‐implantitis.Materials and MethodsTwo hundred and forty randomly selected patients from a university clinic database were invited to participate. Those who accepted, once data from their medical and dental history were collected, were examined clinically and radiographically to assess the prevalence of peri‐implant health and diseases. Peri‐implantitis was defined as the presence of BoP/SoP together with radiographic bone levels (BL) ≧2 mm. An intermediate peri‐implant health category between peri‐implant mucositis and peri‐implantitis was also identified, defined by the presence of BoP/SoP together with 1 mm ≦BL < 2 mm. A multilevel multivariate logistic regression analysis was carried out to identify those factors associated either positively (risk) or negatively (protective) with peri‐implantitis.ResultsNinety‐nine patients with a total of 458 dental implants were analyzed. The prevalences of pre‐periimplantitis and of peri‐implantitis were, respectively, 31.3% and 56.6% at patient‐level, while 31.7% and 27.9% at implant level. The following factors were identified as risk indicators for peri‐implantitis: smoking (OR = 3.59; 95% CI: 1.52–8.45), moderate/severe periodontitis (OR = 2.77; 95% CI: 1.20–6.36), <16 remaining teeth (OR = 2.23; 95% CI: 1.05–4.73), plaque (OR = 3.49; 95% CI: 1.13–10.75), implant malposition (too vestibular: OR = 2.85; 95% CI: 1.17–6.93), implant brand (Nobel vs. Straumann: OR = 4.41;95% CI: 1.76–11.09), restoration type (bridge vs. single crown: OR = 2.47; 95% CI: 1.19–5.12), and trauma as reason of tooth loss (vs. caries: OR = 6.51; 95% CI: 1.45–29.26). Conversely, the following factors were identified as protective indicators: interproximal flossing/brushing (OR = 0.27; 95% CI: 0.11–0.68), proton pump inhibitors (OR = 0.08; 95% CI: 0.01–0.90), and anticoagulants (OR = 0.08; 95% CI: 0.01–0.56).ConclusionsPeri‐implant diseases are highly prevalent among patients with dental implants in this university‐based population. Several factors were identified as risk‐ and protective‐ indicators of peri‐implantitis.

Aim. To evaluate the prevalence of peri-implant diseases and to identify risk/protective indicators of peri-implantitis. Materials and Methods. 240 randomly selected patients from a university clinic database were invited to participate. Those who accepted, once data from their medical and dental history was collected, were examined clinically and radiographically to assess the prevalence of peri-implant health and diseases. A multilevel multivariate logistic regression analysis was carried out to identify those factors associated either positively (risk) or negatively (protective) with peri-implantitis defined as BoP/SoP and bone levels ≥2 mm. Results. 99 patients with a total of 458 dental implants were analyzed. The prevalence of pre-periimplantitis and of peri-implantitis were respectively 56.6% and 31.3% at patient-level, while 27.9% and 31.7% at implant-level. The following factors were identified as risk indicators for peri-implantitis: smoking (OR=3.59; 95%CI:1.52-8.45), moderate/severe periodontitis (OR=2.77; 95%CI:1.20-6.36), <16 remaining teeth (OR=2.23; 95%CI:1.05-4.73), plaque (OR=3.49; 95%CI:1.13-10.75), implant malposition (too vestibular: OR=2.85; 95%CI:1.17-6.93), implant brand (Nobel vs. Straumann: OR=4.41;95% CI:1.76-11.09), restoration type (bridge: OR=2.47; 95%CI:1.19-5.12), and trauma as reason of tooth loss (OR=6.51;95% CI:1.45-29.26). Conversely, the following factors were identified as protective indicators: interproximal flossing/brushing (OR=0.27; 95%CI:0.11-0.68), proton pump inhibitors (OR=0.08; 95%CI:0.01-0.90) and anticoagulants (OR=0.08; 95%CI:0.01-0.56). Conclusions. Peri-implant diseases are highly prevalent among patients with dental implants in this university-based population. Several factors were identified as risk- and protective-indicators of peri-implantitis.

Aim To evaluate the prevalence of buccal peri‐implant soft tissue dehiscence (PISTD) in anterior implants and to identify the risk/protective indicators of PISTD in implants not suffering peri‐implantitis. Materials and methods 240 randomly selected patients from a university clinic database were invited to participate in the present cross‐sectional study. Those who accepted, after the evaluation of their medical and dental records, were clinically examined to assess the prevalence of buccal PISTD in non‐molar implants. Multilevel multivariate logistic regression analyses were then carried out to identify those factors associated either positively (risk) or negatively (protective) with buccal PISTD in implants without peri‐implantitis. Results 92 patients with a total of 272 dental implants were analysed. At implant‐level, the prevalence of buccal PISTD was 16.9%, while when selecting only implants without peri‐implantitis it was 12.0%. Buccal PISTD was present in 26.7% of the implants diagnosed with peri‐implantitis. The following factors were identified as risk/protective indicators of buccal PISTD in implants without peri‐implantitis: malposition (too buccal vs. correct: OR=14.67), thin peri‐implant phenotype (OR=8.31), presence of at least one adjacent tooth (OR=0.08) and presence of abutment (OR=0.12). Conclusions PISTD are highly prevalent among patients with dental implants in this university‐based population, and several factors were identified as risk and protective indicators of PISTD in implants not suffering peri‐implantitis.

ObjectivesTo study the symptoms and perception reported by patients with peri‐implant diseases, as well as their signs and their potential impact on the oral health quality of life.Material and MethodsTwo hundred and forty randomly selected patients were invited to participate. As part of the history assessment, the patient OHIP‐14Sp was evaluated together with, for each implant, the patient perception regarding the peri‐implant health status and the history of pain, spontaneous discomfort, bleeding, suppuration, swelling, and discomfort during brushing. As part of the clinical examination, the following potential signs of peri‐implant diseases were collected: probing pocket depth (PPD), mucosal dehiscence (MD), extent of BoP, presence of SoP, and visual signs of redness and swelling. Those parameters were analyzed in relation to the actual peri‐implant health diagnosis.ResultsNinety‐nine patients with a total of 458 dental implants were studied. Even in case of peri‐implantitis, 88.9% of the implants were perceived by the patients as healthy. The total OHIP‐14Sp sum score did not differ in relation to the peri‐implant health diagnosis. Increased reports of spontaneous discomfort, bleeding, swelling, and discomfort during brushing were observed in presence of disease. However, only a minor proportion of implants with peri‐implant diseases presented symptoms. PPD ≥ 6 mm was more frequent in diseased than in healthy implants (p < .01), while PPD ≥ 8 in pre‐peri‐implantitis/peri‐implantitis than in healthy/mucositis implants (p < .01). Implants with peri‐implantitis showed higher MD than implants without peri‐implantitis (p < .01).ConclusionPeri‐implant diseases are in most cases asymptomatic and not perceived by the patients. Despite being unable to accurately discriminate between peri‐implant mucositis and peri‐implantitis, PPD and MD resulted as the only two clinical signs associated with pre‐peri‐implantitis/peri‐implantitis.

Aim: To study the symptoms and perception reported by patients with peri-implant diseases, as well as their signs and their potential impact on the oral health quality of life. Materials and Methods: 240 randomly selected patients were invited to participate. As part of the history assessment, the patient OHIP-14Sp was evaluated together with, for each implant, the patient perception regarding the peri-implant health status and the history of pain, spontaneous discomfort, bleeding, suppuration, swelling and discomfort during brushing. As part of the clinical examination, the following potential signs of peri-implant diseases were collected: probing pocket depth (PPD), mucosal dehiscence (MD), extent of BoP, presence of SoP, and visual signs of redness and swelling. Those parameters were analyzed in relation to the actual peri-implant health diagnosis. Results: 99 patients with a total of 458 dental implants were studied. Even in case of peri-implantitis, 88.89% of the implants were perceived by the patients as healthy. The total OHIP-14Sp sum score did not differ in relation to the peri-implant health diagnosis. Increased reports of spontaneous discomfort, bleeding, swelling and discomfort during brushing were observed in presence of disease. However, only a minor proportion of implants with peri-implant diseases presented symptoms. PPD≥6 mm was more frequent in diseased than in healthy implants (p<0.01), while PPD≥8 in pre-periimplantitis/peri-implantitis than in healthy/mucositis implants (p<0.01). Implants with peri-implantitis showed higher MD than implants without peri-implantitis (p<0.01). Conclusions: Peri-implant diseases are in most cases asymptomatic and not perceived by the patients. Despite being unable to accurately discriminate between peri-implant mucositis and peri-implantitis, PPD and MD resulted as the only two clinical signs associated with pre-periimplantitis/peri-implantitis.

Aim: The present multi-centre randomized clinical trial with 12 months of follow-up aimed at studying the added effect of sub-marginal instrumentation before surgical treatment of peri-implantitis.Materials and Methods: Forty-two patients diagnosed with peri-implantitis were recruited. After a behavioural intervention phase including oral hygiene instructions, patients were randomized to either receiving supra-and sub-marginal instrumentation on their affected implants (control group: 21 patients and 29 implants) or only supra-marginal instrumentation (test group: 21 patients and 24 implants), before undergoing surgery. Changes in the deepest probing pocket depth (PPD) with respect to baseline and a composite outcome of treatment success (no implant loss, no bone loss > 0.5 mm, no bleeding or suppuration on probing [BoP/SoP], and PPD ≤ 5 mm) at the 12-month examination were regarded as the primary outcomes of the trial.Results: At the 12-month examination, changes in the deepest PPD with respect to baseline amounted to À2.96 mm in the control group and to À3.11 mm in the test one (MD = À0.16; SE = 0.56; p = .769), while 21.4% of the implants in the control group and 33.3% in the test group presented treatment success (OR = 1.83; SE = 1.15; p = .338). With the exception of a longer non-surgical treatment duration in the control group (differences in = À14.29 min; SE = 2.91; p < .001), no other secondary (e.g., soft-tissue recession, keratinized mucosa height, and bone level changes, as well as BoP, SoP, profuse bleeding and implant loss rates) or exploratory (i.e., early wound healing, aesthetics, surgical and total treatment duration, surgery difficulty, intra-operative bleeding, and adverse events) outcome demonstrated statistically significant differences between groups. Conclusions:The present multi-centre randomized clinical trial did not demonstrate an added effect of performing sub-marginal instrumentation 6 weeks before the

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