Iatrogenic Peri‐Implantitis—Factors Interplaying the Implant Suprastructure Design

Abstract

Focused Clinical Question What is the key clinically controllable preventive measure that may help reduce the incidence of biological complications? Summary Implant complications are common, ineffective care, and delay in diagnosis can lead to expensive time‐consuming surgical and nonsurgical interventions. Careful selection and placement of implant allow development of adequate emergence design of the implant suprastructure. This helps achieve effective plaque control, adequate maintenance at hygiene visits, accurate follow‐up assessments of the peri‐implant tissues addressing the key underlying factor impacting biological complications. This clinically controllable preventative measure may be considered a vital strategy in averting peri‐implant disease. Conclusions Surge in biological complications has led to increased patient dissatisfaction in terms of time, cost, esthetics, and maintenance. One of the factors identified in causing biological complications is the iatrogenic prosthesis‐related factor. Minimizing the impact of this factor is crucial to the overall implant success. Selection and placement of implant following meticulous planning, using careful surgical protocols, allow development of adequate suprastructure design that improves overall patient outcomes by reducing biological complications. Further research is essential to comprehensively assess the impact of these strategies in thwarting development of biological complications.

In vitro efficacy of non‐surgical and surgical implant surface decontamination methods in three different defect configurations in the presence or absence of a suprastructure

“…Considering aesthetic aspects, in everyday clinical practice and against the background of peri-implant disease prevalence, 33 prosthetic suprastructures on implants should be designed to allow easy access for cleaning of the implant surface. 27,34,35 It is easier to remove a screwretained suprastructure than a cemented one, and biological complications, such as those caused by remaining cement residues, can be avoided. Another conclusive aspect influencing the cleaning efficacy is the design of the emergence profile/angle in the case of an existing suprastructure.…”

“…Another conclusive aspect influencing the cleaning efficacy is the design of the emergence profile/angle in the case of an existing suprastructure. [35][36][37] This promotes easier (flat angle) or more difficult (steep angle) accessibility depending on the angle between the implant axis and the crown base. Because the suprastructure remained the same throughout this study, this factor did not play a significant role.…”

“…Linear regression analysis revealed that the cleaning efficacy was 10% higher in the absence of a suprastructure than in the presence of one. Considering aesthetic aspects, in everyday clinical practice and against the background of peri‐implant disease prevalence, 33 prosthetic suprastructures on implants should be designed to allow easy access for cleaning of the implant surface 27,34,35 . It is easier to remove a screw‐retained suprastructure than a cemented one, and biological complications, such as those caused by remaining cement residues, can be avoided.…”

“…It is easier to remove a screw‐retained suprastructure than a cemented one, and biological complications, such as those caused by remaining cement residues, can be avoided. Another conclusive aspect influencing the cleaning efficacy is the design of the emergence profile/angle in the case of an existing suprastructure 35‐37 . This promotes easier (flat angle) or more difficult (steep angle) accessibility depending on the angle between the implant axis and the crown base.…”