Immediate loading of 5 fluoride-modified dental implants with a fixed prosthetic rehabilitation is a predictable and reliable treatment in the edentulous mandible, based on a 100% implant survival and limited peri-implant bone loss. Implants used for immediate loading in the edentulous mandible who are showing early bone loss may be at higher risk to develop peri-implantitis.

Purpose To evaluate the effect of early bone loss (EBL), on long‐term bone stability and future peri‐implantitis development. Materials and methods Patients referred for implant placement between 2005 and 2009 were consecutively treated and followed for 10 years. After 10 years, patients were invited for a scientific diagnostic visit to evaluate implant survival and bone loss. Bone level changes were compared with baseline. Non‐parametric testing was performed in cross‐tabs (Pearson Chi‐square and Fishers's exact test). Kaplan–Meier‐estimated survival curves were plotted for different thresholds for EBL at different timepoints. Generalized linear mixed models with binomial distribution and logit link for peri‐implantitis were fitted. An adjusted logistic mixed model was made to evaluate peri‐implantitis, in relation with smoking status, history of periodontitis, and EBL > 0.5 mm. Results Four hundred and seven patients (mean age of 64.86 years [range 28–92, SD 10.11]), with 1482 implants, responded to the 10‐year recall invitation. After an average follow‐up time of 10.66 years (range 10–14, SD 0.87), implant survival was 94.74%. Mean crestal bone loss after 10 years was 0.81 mm (SD 1.58, range 0.00–17.00). One hundred and seventy five implants in 76 patients had peri‐implantitis (11.8% on implant level, 18.7% on patient level). EBL of 0.5, 1, and 2 mm were significant predictors for peri‐implantitis and implant loss after 10 years. Implants with EBL ≥0.5 mm during the first year of function showed a 5.43 times higher odds for future peri‐implantitis development. Probability in developing peri‐implantitis was 52.06% when smoking, Periodontal history and EBL of >0.5 mm was combined. Conclusion The present study suggests that EBL is a predictor for long‐term peri‐implant pathology, with a significant higher risk for peri‐implantitis when early bone loss exceeds the thresholds of 0.5 and 1 mm, especially when additional risk factors such as smoking or susceptibility for periodontal disease prior to implant treatment are present. Clinical trial registration number B670201524796.

Background: The purpose of this study was to compare the survival and peri-implant bone loss of implants with a fluoride-modified surface in smokers and non-smokers. Material and Methods: All patients referred for implant treatment between November 2004 and 2007 were scrutinized. All implants were placed by the same surgeon (B.C.). The single inclusion criterion was a follow-up time of at least 10 years. Implant survival, health, and bone loss were evaluated by an external calibrated examiner (S.W.) during recall visits. Radiographs taken at recall visits were compared with the post-surgical ones. Implant success was based on two arbitrarily chosen success criteria for bone loss (≤1 mm and ≤2 mm bone loss after 10 years). Implant survival in smokers and non-smokers was compared using the log-rank test. Both non-parametric tests and fixed model analysis were used to assess bone loss in both groups. Results: A total of 453 implants in 121 patients were included for survival analysis, and 397 implants in 121 patients were included for peri-implant bone-loss analysis. After a mean follow-up time of 11.38 years (SD 0.78; range 10.00–13.65), 33 implants out of 453 initially placed had failed in 21 patients, giving an overall survival rate of 92.7% and 82.6% on the implant and patient level, respectively. Cumulative 10 years’ survival rate was 81% on the patient level and 91% on the implant level. The hazard of implant loss in the maxilla was 5.64 times higher in smokers compared to non-smokers (p = 0.003). The hazard of implant loss for implants of non-smokers was 2.92 times higher in the mandible compared to the maxilla (p = 0.01). The overall mean bone loss was 0.97 mm (SD 1.79, range 0–17) at the implant level and 0.90 mm (SD 1.39, range 0–7.85) at the patient level. Smokers lost significantly more bone compared to non-smokers in the maxilla (p = 0.024) but not in the mandible. Only the maxilla showed a significant difference in the probability of implant success between smokers and non-smokers (≤1 mm criterion p = 0.003, ≤2 mm criterion p = 0.007). Taking jaw into account, implants in smokers experienced a 2.6 higher risk of developing peri-implantitis compared to non-smokers (p = 0.053). Conclusion: Dental implants with a fluoride-modified surface provided a high 10 years’ survival with limited bone loss. Smokers were, however, more prone to peri-implant bone loss and experienced a higher rate of implant failure, especially in the upper jaw. The overall bone loss over time was significantly higher in smoking patients, which might be suggestive for a higher peri-implantitis risk. Hence, smoking cessation should be advised and maintained after implant placement from the perspective of peri-implant disease prevention.

Background: It is widely perceived that following implant placement and abutment connection, a limited bone loss (defined in literature as marginal bone loss or initial bone loss or initial bone remodelling) may occur. This is basically biologically driven as a result of establishment of a biologic seal between soft tissues and implant and/or restorative components. On the other hand, this initial crestal bone remodelling may also lead to unwanted implant surface exposure to soft tissues. Aim/Hypothesis: To evaluate if early bone loss, including initial bone loss (IBL), is predictive for future development of peri-implantitis and implant loss. Materials and Methods: All patients were initially referred by their general dentist and treated between 2005 and 2009 with the same implant system (OsseoSpeed, Dentsply Sirona Implants). The single inclusion criterion was a follow-up time of at least 10 years. Implant survival, health and bone loss were evaluated during recall visits. Radiographs taken at recall visits were compared with the post-surgical ones (baseline). Simple NO-parametric testing was performed in cross-tabs using Pearson Chi-square test and Fishers's exact test. Kaplan-Meier estimated survival curves were plotted for different thresholds for IBL (0.5 mm and 1 mm) at different times (1-and 2-years post-op). Simple generalized linear mixed models with binomial distribution and logit link for peri-implantitis were fitted. An adjusted logistic mixed model was made for peri-implantitis, with adjustment for smoking status, history of periodontitis and IBL at 1 year >0.5 mm. Results: 407 patients (221 women, 186 men; mean age of 64.86 years (range 28-92, SD 10.11)), with 1482 implants, responded. Average follow-up time was 10.66 years (range 10-14, SD 0.87). Absolute implant survival rate was 94.74%. MBL of 0.81 mm (SD 1.58, range 0.00-17.00) was seen after a follow-up of 10 years. 175 implants (76 patients) were diagnosed with peri-implantitis (11.81% on implant level, 18.67% on patient level). Differences between groups for each threshold were statistical significant for both peri-implantitis and implant loss. Implants with >0.5 mm IBL during the 1st year of function show 5.43 times higher risk in developing peri-implantitis. Probability in developing periimplantitis was 52.06% when smoking, susceptibility for periodontitis and IBL of >0.5 mm was combined. Conclusions and Clinical Implications: The present study suggests that early bone loss is a predictor for development of long-term periimplant pathology, with a significant higher risk for peri-implantitis when early bone loss exceeds certain proposed thresholds.