Association of prosthetic features and peri‐implantitis: A cross‐sectional study

Abstract

Objective: To identify the influence of prosthetic features through a comprehensive analysis with other known risk factors. Materials and methods:A total of 169 patients (n = implants: 349) was retrospectively included in the present study. Peri-implantitis was diagnosed based on periimplant bone loss and probing depth. Using radiographs taken 1 and 5 years following prosthesis insertion, the following features were determined: peri-implant marginal bone loss (MBL), emergence angle (EA), emergence profile (EP) and crown/implant ratio (CIR). The splinted position of prosthesis was also recorded. Multivariable generalized estimating equation was used to analyse the influence of each feature on the prevalence of peri-implantitis. The final prediction model was constructed by Cox proportional hazard regression analysis. Results:The EA showed a significant correlation with MBL. A statistically greater prevalence of peri-implantitis was observed if EA ≥ 30 degrees, when EP is convex and in middle implant splinted with both mesial and distal adjacent implants in bonelevel implant. A similar correlation was not observed in tissue-level implants. CIR had no significant effect on the prevalence of peri-implantitis. Conclusion:Over-contoured implant prosthesis is a critical local confounder for peri-implantitis. The implant splinted to both mesial and distal adjacent implant has a higher risk of peri-implantitis. K E Y W O R D Semergence angle, emergence profile, Peri-implantitis, restoration contour, splinted

Influence of restorative design on the progression of peri‐implant bone loss: A retrospective study

“…Data from this study also found that, during the first year after the development of peri‐implantitis, implants with restoration emergence angles of >30° had around 1.74 mm more peri‐implant bone loss than when restoration emergence angles were ≤30°. This is in support of findings from other studies 23,24 . Katafuchi et al.…”

“…Patients having factors such as a history of severe periodontitis, poor plaque control, and no regular maintenance care after implant therapy have been shown to be more prone to this disease 21 . Other factors such as implant position, smoking, diabetes, the presence of periodontitis at time of placement, restoration emergence angle, amount of keratinized mucosa, presence of residual cement, and titanium particles, have also been linked to peri‐implantitis but require more evidence 23–30 . However, only little importance has been given to the factors that may increase the progression of peri‐implant bone loss once peri‐implantitis has developed.…”

“…Therefore, studying the early disease progression pattern of peri‐implantitis and the factors that could affect peri‐implantitis‐associated bone loss is critical. In addition, most of the early studies evaluating factors associated with peri‐implantitis focused on biological associated events, 35–37 however, recently, studies are featuring the restorative aspect as well 23,24 . In a study evaluating the effect of prosthetic features on peri‐implantitis, Yi et al.…”

“…In a study evaluating the effect of prosthetic features on peri‐implantitis, Yi et al. found that implants with restoration emergence angle ≥30° had significantly more marginal bone loss compared with implants with restoration emergence angle <30°, 5 years following functional loading 24 . When implants are in function, occlusal forces propagate from the occlusal surfaces to the implant‐abutment connection and further to the internal screw of the implant 38,39 .…”

Peri-implantitis Update: Risk Indicators, Diagnosis, and Treatment

“…An implant splinted to both a mesial and distal adjacent implant has a higher risk of peri-implantitis. 24 Cement causes roughness, favors bacterial attachment and foreign body reactions, and results in peri-implantitis. Removing the cement results in the resolution of inflammation in a few days to weeks and can be done using a closed procedure (dental endoscope) or open surgical flap procedure.…”