Clinical findings and history of bone loss at implant sites

Berglundh, Jessica; Romandini, Mario; Derks, Jan; Sanz, Mariano; Berglundh, Tord

doi:10.1111/clr.13701

Cited by 24 publications

(25 citation statements)

References 30 publications

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“…This is because according to those results, this low sensitivity indicates a high inability to diagnose diseased implants, as truly pathological. Moreover, the validity of the proposed clinical criteria for the diagnosis of peri‐implantitis is also in question, since they also have reported that while blood on probing showed a high level of sensitivity, the sensitivity of probing pocket depth was generally low 32 . But even more, bleeding on probing must be interpreted with caution, as it may originate not only because of a true pathological condition but also as a consequence of trauma upon the own maneuver of probing 33 …”

Section: Discussionmentioning

confidence: 99%

“…In fact, in the Swedish study series initiated by Derks and colleagues, 20% of measurements were made on panoramic radiographs 10 . Moreover, more recent studies conducted and published by others also use data from panoramic radiographies to analyze MBL around implants 7,32 . It is remarkable that in the most recent consensus, 2,73 “intraoral radiographies” are not required specifically, surely due to the important limitations of the intraoral radiographies described above.…”

Section: Discussionmentioning

confidence: 99%

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Early marginal bone loss around dental implants to define success in implant dentistry: A retrospective study

Galindo‐Moreno

Catena

Pérez‐Sayáns

et al. 2022

Clin Implant Dent Rel Res

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Purpose The aim of this study was to establish an objective criterion in terms of marginal bone level (MBL) to know the prognosis of an implant. Materials and Methods A group of 176 patients in whom 590 implants were placed were included in this retrospective study. Patients older than 18 years, presenting either Kennedy class I or II edentulous section, or totally edentulous at least in one of the dental arches were included in this study. Those with any type of disturbance able to alter bone metabolism or with nontreated periodontal disease were excluded. Data on radiographic MBL at loading, 6 and 18 months later, age, gender, smoking habits, history of periodontitis, bone substratum, implant, and prosthetic features were recorded. Nonparametric receiver operating curves (ROC) were constructed for the MBL at 18 months in order to establish a distinction among high bone loser (HBL) and low bone loser (LBL) implants. Differences as a function of main variables were also determined, particularly abutment height and periodontal disease. Results HBL implants lost at least 0.48 mm of MBL 6 months after loading; they reached at least 2 mm of MBL 18 months after loading. MBL rate followed a nonlinear trend, except in implants restored over long prosthetic abutments and in patients with history of severe periodontitis; in whom the rate of MBL over the time was nearly zero. Conclusion Implants that lose more than 0.5 mm of marginal bone 6 months after loading are at great risk of not being radiographically successful anymore. Therefore, 0.5 mm of MBL is proposed as a distinctive and objective criterion of success in Implant Dentistry within a 6‐month follow‐up period. A prosthetic abutment height ≥2 mm resulted the most protective factor in the peri‐implant bone maintenance.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Early marginal bone loss around dental implants to define success in implant dentistry: A retrospective study

Galindo‐Moreno

Catena

Pérez‐Sayáns

et al. 2022

Clin Implant Dent Rel Res

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“…Other limitations of the present study include the absence of a control group and the retrospective design of the study and the lack of longitudinal assessment of interproximal radiographic bone level, due to the strict compliance with the current national legislation. As clinical parameters (BOP and PD) can be considered predictors of disease progression (Berglundh et al, 2021; Carcuac et al, 2017; Karlsson et al, 2019), the sole presence of BOP+ in absence of PD values ≥6 mm was not considered sufficient for taking x‐rays. Indeed, in these circumstances the therapeutic approach would have been in the first place non‐surgical no matter what.…”

Section: Discussionmentioning

confidence: 99%

Two‐piece zirconia implants in the posterior mandible and maxilla: A cohort study with a follow‐up period of 9 years

Brunello

Rauch

Becker

et al. 2022

Clinical Oral Implants Res

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Objectives: Long-term follow-up observations of zirconia implants are rare. This study aimed at evaluating the clinical performance of two-piece zirconia implants in the posterior jaws over 9 years. Materials and Methods:Sixty partially edentulous patients were treated with twopiece zirconia implants. In eight no primary stability could be achieved. Fifty-two patients received the final restoration (i.e., cemented fibreglass abutments and allceramic crowns). After 2 years, 2 implants failed and 4 dropouts were recorded. The remaining 46 patients with one target implant each were recalled at 9 years. Besides implant survival, clinical parameters at the implant level (plaque index-PI, bleeding on probing-BOP, probing depth-PD, mucosal recession-MR) were recorded and compared with previously collected data. Mechanical and technical complications were assessed.Results: Thirty patients responded. The mean observation period was of 111.1 ± 2.2 months. One implant was lost. Data recorded from the remaining 29 implants were analysed. PI values increased overtime. Mean BOP and PD remained unchanged during follow-up. No additional cases of peri-implantitis were recorded over the 10 diagnosed during the first 2 years of follow-up. No significant changes in mean MR values were detected over time, with 65% of the all included implants exhibiting no recession at 9 years and all the others, but one, a maximum MR of 1 mm. Three technical and 6 mechanical complications occurred in 7 patients between 2-and 9years (6.9% and 20.7%, respectively, at patient level). Conclusion:Within the limitations of the present study, a high survival rate was registered. Albeit frequent mechanical and technical complications, two-piece zirconia implants could represent a valid solution for the replacement of single teeth in the posterior jaws.

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“…The present study has some limitations mainly related with the nature of the available literature. Several factors such as implant surface characteristics, 63 configuration of peri-implant defect, 64, 65 frequency and quality of supportive therapy 8, 66 can affect the results of surgical treatment of peri-implantitis, but none of these factors could be considered in the present meta-analyses. Furthermore, 6-month follow-up in some of the included RCTs may be too short for detection of significant effect on MBL changes and may not account for the relatively high incidence of disease recurrence following surgical therapy of peri-implantitis.…”

Section: Discussionmentioning

confidence: 99%

Impact of surface decontamination and systemic antimicrobials for surgical treatment of peri-implantitis: A systematic review and meta-analysis of randomized clinical trials

Baima

Citterio

Romano

et al. 2021

Preprint

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BackgroundEfficient control of infection is essential to achieve desired outcomes in the surgical treatment of peri-implantitis lesions, although methods employed are largely heterogeneous.PurposeTo compare the impact of different decontamination protocols and adjunctive systemic antimicrobials on the outcomes of surgical treatment of peri-implantitis.Materials and methodsRandomized clinical trials (RCTs) on surgical treatment of peri-implantitis were selected through an electronic search on Medline, Embase, Scopus, and Central databases. Only studies comparing two or more anti-infective strategies were included. Following data extraction, two different sets of meta-analyses were performed. Firstly, overall impact of different implant surface decontamination methods was assessed by comparing baseline values with outcomes at 6-12 months. Secondly, pairwise comparisons evaluated the potential benefit of adjunctive systemic antimicrobials over placebo. Results were expressed as weighted mean effect (WME), weighed mean difference (WMD) or risk ratio (RR).ResultsSixteen RCTs were included. No pairwise comparisons were available for different surface decontamination methods. Use of curettes resulted in improved probing depth (PD) (WME = 2.13 mm), but the results in terms of marginal bone levels (MBL) and percentage of disease resolution were unsatisfactory. Moreover, the adjunctive benefit of systemic antimicrobials over placebo was evaluated in two studies, representing a total of 178 implants. Despite not being statistically significant, the meta-analyses identified a higher probability of disease resolution (RR = 1.50) for test procedures. In terms of overall outcome, systemic antimicrobials with open flap debridement resulted in improved MBL (WME = 0.44 mm), reduced PD (WME = 2.46 mm) and 51.4% of disease resolution.ConclusionsThere is not enough evidence to support adjunctive usage of systemic antimicrobials together with the surgical treatment of peri-implantitis. Moreover, higher consistency is required to prove the superiority of a surface decontamination protocol over another (PROSPERO CRD42020182303).SUMMARY BOXWhat is knownPeri-implantitis is a common biological complication occurring at dental implants, and surgery is usually required to obtain thorough peri-implant infection control.No systematic reviews with meta-analysis have assessed surface decontamination protocols for surgical treatment of peri-implantitis, as well as the adjunctive benefit of peri-operative systemic antimicrobials.What this study addsThis study offered the first evidence-based synthesis of randomized clinical trials regarding this relevant topic.Although protocol heterogeneity was high, a combination of mechanical and chemical implant surface decontamination is recommendable.Titanium brushes and local delivery of minocycline showed encouraging results; while the additional benefit of systemic antimicrobials needs to be further determined.

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Clinical findings and history of bone loss at implant sites

Cited by 24 publications

References 30 publications

Early marginal bone loss around dental implants to define success in implant dentistry: A retrospective study

Early marginal bone loss around dental implants to define success in implant dentistry: A retrospective study

Two‐piece zirconia implants in the posterior mandible and maxilla: A cohort study with a follow‐up period of 9 years

Impact of surface decontamination and systemic antimicrobials for surgical treatment of peri-implantitis: A systematic review and meta-analysis of randomized clinical trials

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