Diagnostic characteristics of clinical and microbiological tests for monitoring periodontal and peri‐implant mucosal tissue conditions during supportive periodontal therapy (SPT)

Abstract

The aim of this study was to evaluate a clinical and a microbiological test for monitoring tissue condition during supportive periodontal therapy (SPT) and to compare their diagnostic characteristics at implant and tooth sites. Twelve female (age: 37-72 years) and 7 male patients (age: 26-83 years) were evaluated in this study on the basis of availability to follow a rigid SPT program. Patients had received a complete periodontal examination at 1 and 5 years after implant placement. This included standardized radiographs obtained at implants and matching control teeth. One implant site and one tooth site per patient were followed during the last 2 years of the SPT program. At each recall visit microbiological samples were analyzed according to DNA/RNA analysis identifying periodontal pathogens (IAI Pado Test 4.5, Institute for Applied Immunology, Zuchwil, Switzerland). Presence or absence of bleeding on probing at these sites was also noted using a standardized probing force of 0.25 N (Audio Probe, ESRO, Thalwil ZH, Switzerland). The percentage number of recall visits with positive bacteriological test results and positive BOP scores were calculated. Disease progression at the sites was defined if the annual increase in probing depth was > or = 0.5 mm/year (2.5 mm in 5 years) or if the annual decrease in CADIA values (Computer Assisted Densitometric Image Analysis) was more than -0.7 per year (-3.5 in 5 years). Changes below these values were considered as negative test results indicating stability of the sites. The diagnostic characteristics (sensitivity, specificity, positive and negative predictive values) of BOP and microbiological tests alone or in combination were then calculated using two-by-two tables. By application of increasing thresholds of BOP frequencies set for definition of positive test outcome (BOP > or = 10% > or = 20% > or = 25% > or = 50% > or = 75% > or = 90% or the combined BOP > or = 75%, but DNA positive > or = 10%, > or = 25% > or = 34% > or = 50% > or = 67% > or = 90%) receiver operator characteristics curves (ROC) were constructed for teeth and implants. The areas under the ROC curves were calculated and compared by means of chi-square tests. The results indicated statistically significant better diagnostic characteristics of both tests at implants compared to teeth. The inclusion of an additional microbiological test significantly enhanced the diagnostic characteristics of BOP alone at teeth as well as at implants.

Clinical and radiographic evaluation of NobelActiveTM dental implants

“…Additional clinical tests such as salivary analysis, peri-implant crevicular fluid analysis, and microbiological testing (Luterbacher et al 2000) have been suggested to be beneficial adjuncts to diagnosis and prediction of disease progression. Resonance frequency analysis has also been shown to detect minor changes in the level of boneimplant contact (Meredith et al 1996).…”

Reliability of periodontal diagnostic methods in the assessment of periimplant health: A comparison of the correlations amongst some clinical parameters

“…Bunun tam tersi olarak, sağlıklı implant dokularında sondalamada kanama kriterinin idame fazında tanısal önem taşıdığını mikrobiyolojik ve histolojik testlerle destekleyen çalışmalar da bulunmaktadır. 27,28 Yüksek Gİ skorlarına sahip implant grubumuzun yüksek SK skorlarına sahip olması beklenebilen bir sonuçtur. Bununla birlikte, Gİ ile SK arasında hem doğal dişler grubunda hem de implant grubunda pozitif yönde korelasyon bulunmuş-tur.…”

Taller 5 - Peri-implantitis

“…Numerosos estudios han encontrado una relación directa entre el SS y la pérdida de inserción alrededor del implante. Un estudio prospectivo cuyo objetivo fue monitorear las condiciones de la mucosa periimplantar durante la terapia periodontal de apoyo, reveló que el sangrado en un mismo sitio, en más de la mitad de las visitas de mantenimiento, durante un período de 2 años se relaciona con el progreso de la enfermedad (6) .…”

“…Numerous studies have found a direct link between bleeding on probing and suppuration and attachment loss around the implant. A prospective study that monitored the conditions of the peri-implant mucosa during supportive periodontal therapy found that bleeding on the same site, in over half of recall visits, in a period of two years, was related to the progression of the disease (6) .…”