How do peri‐implant biologic parameters correspond with implant survival and peri‐implantitis? A critical review

Abstract

ObjectivesThe aim of this critical review was to evaluate whether commonly used biologic diagnostic parameters correspond to implant survival and peri‐implantitis prevalence.Materials and methodsPublications from 2011 to 2017 were selected by an electronic search using the Pubmed database of the US National Library of Medicine. Prospective and retrospective studies with a mean follow‐up time of at least 5 years and reporting prevalence of peri‐implantitis as well as mean bone loss and standard deviation were selected. The correlation between reported prevalence of peri‐implantitis and reported implant survival, mean follow‐up time, mean bone loss, mean probing depth, and mean bleeding on probing was calculated. Mean bone loss and standard deviation were used for estimation of proportion of implants with bone loss exceeding 1, 2, and 3 mm.ResultsFull‐text analysis was performed for 255 papers from 4,173 available ones, and 41 met all the inclusion criteria. The overall mean weighted survival rate was 96.9% (89.9%–100%) and the reported prevalence of peri‐implantitis ranged between 0% and 39.7%, based on 15 different case definitions. The overall weighted bone loss was 1.1 mm based on 8,182 implants and an average mean loading time ranging from 5 to 20 years. No correlation was found between mean bone loss and the reported prevalence of peri‐implantitis. The estimated prevalence of implants with bone loss above 2 mm was 23%. The overall weighted mean probing depth was 3.3 mm, and mean weighted bleeding was 52.2%. Only a weak correlation was found between survival and function time (r = −0.49). There was no relation between the probing depth or bleeding and the mean bone loss, mean follow‐up time, and reported prevalence of peri‐implantitis.ConclusionBiologic parameters mean probing depth and mean bleeding on probing do not correlate with mean bone loss and this irrespective of follow‐up. Case definition for peri‐implantitis varied significantly between studies indicating that an unambiguous definition based on a specified threshold for bone loss is not agreed upon in the literature.

Two to six‐year disease resolution and marginal bone stability rates of a modified resective‐implantoplasty therapy in 32 peri‐implantitis cases

“…This is supported on the last consensus report 1 and other studies27 which stablish that peri-implant health is characterized by absence of erythema, bleeding on probing, swelling, suppuration, and that a peri-implant probing depth compatible to health cannot be stablished. This is supported on the last consensus report 1 and other studies27 which stablish that peri-implant health is characterized by absence of erythema, bleeding on probing, swelling, suppuration, and that a peri-implant probing depth compatible to health cannot be stablished.…”

“…19,[25][26][27] Studies have reported that the clinical prognosis of peri-implantitis resective therapy could be influenced by pre-surgical initial probing depths of more than 7mm. 19,[25][26][27] Studies have reported that the clinical prognosis of peri-implantitis resective therapy could be influenced by pre-surgical initial probing depths of more than 7mm.…”

Biological and technical outcomes of restored implants after maxillary sinus augmentation—Results at 1‐year loading

“…Whilst the absence of BOP has a high negative predictive value for disease progression ( Abbreviations: AB, autogenous bone; ABBM, anorganic bovine bone mineral; ABBM-C, collagen-stabilized anorganic bovine bone mineral; BOP, bleeding on probing; DIM, gingival marginal position; IQR, inter-quartile range; PI, plaque index; PPD, probing pocket depth; SD, standard deviation; T1, baseline; T2, 12 months after function. Luterbacher, Mayfield, Bragger, & Lang, 2000), the significance of a single recording of positive BOP in determining disease progression is not determined and its dichotomous nature limits its correlation to disease status and severity (Doornewaard, Jacquet, Cosyn, & Bruyn, 2018) (Sanz-Sanchez et al, 2018). Furthermore, excessive probing force may induce false positive readings (Gerber, Tan, Balmer, Salvi, & Lang, 2009), and therefore, probing force cannot be discounted as a source of error in this study especially in the presence of low plaque scores.…”

“…A high rate of peri‐implant mucositis is also reported in a recent systematic review reporting a prevalence of 19%–65% (Derks & Tomasi, ). Whilst the absence of BOP has a high negative predictive value for disease progression (Coli, Christiaens, Sennerby, & Bruyn, ; Luterbacher, Mayfield, Bragger, & Lang, ), the significance of a single recording of positive BOP in determining disease progression is not determined and its dichotomous nature limits its correlation to disease status and severity (Doornewaard, Jacquet, Cosyn, & Bruyn, )(Sanz‐Sanchez et al, ). Furthermore, excessive probing force may induce false positive readings (Gerber, Tan, Balmer, Salvi, & Lang, ), and therefore, probing force cannot be discounted as a source of error in this study especially in the presence of low plaque scores.…”

Antiseptic sealant and a nanocoated implant‐abutment interface improve the results of dental implantation

“…Nevertheless, the results obtained in previous studies, as well as in this research, should be interpreted with a high degree of caution. In their analytical review, Doornewaard et al compared the results of 255 full‐text works with an average follow‐up period of at least 5 years after implantation, using comparable methods for assessing peri‐implantitis and mean bone tissue loss. The implantation success rate was 96.9% (from 89.9% to 100%), and the total weighted bone loss was 1.2 mm in the study of 8182 implants.…”