Implant health and factors affecting peri‐implant marginal bone alteration for implants placed in staged maxillary sinus augmentation: A 5‐year prospective study

Abstract

Purpose Evaluating the extent of and the factors affecting marginal bone level (MBL) alterations and consecutively implant success and implant health for implants placed in staged maxillary sinus floor (SF) augmentation. Materials and Methods A 5‐year prospective, cohort study was conducted on 85 patients with 124 maxillary sinus augmentation procedure and 295 implants placed. Peri‐implant MBL alterations (reductions) were evaluated radiographically at the first year, third year, and fifth year postloading follow‐ups and were considered to patient‐related risk factors (age, gender, diabetes mellitus, smoking, rheumatic disorders, and history of periodontal disease [PD]), to clinican/surgically related risk factors (membrane perforations, sinus site, and residual ridge height), to implant/prosthesis‐related features (implant length, diameter, location, keratinized gingiva, and restoration gap), and to the plaque score. Additionally, implant and prostheses survival/success rate and peri‐implant health (mucositis/peri‐implantitis) were assessed. Results About 267/295 implants (drop‐out:n9 pat; 28 implants: 9%) were followed for 5 years (survival/success: 99.3%/96.5%), presenting significant (P < .001) differences of MBL alterations (−1.45 ± 0.38 mm) over time. The univariate analysis demonstrated differences of MBL alterations for smokers versus nonsmokers (P = .005), for patients with versus without history of PD (P = .001), and presence versus absence of plaque (P = .041). In the 5‐year multivariate analysis, MBL alteration was influenced by time (P = .001) and was related to risk factors as smoking (P = .001; odds ratio [OR] = 6.563) and history of PD (P = .015; OR = 4.450). Significant ORs for MBL alterations were also found for a restoration gap used for a full‐arch dentures (P = .001; OR = 8.275) associated with reduced (≤3 mm) residual ridge height (P = .015; OR = 1.365). The overall 5 year incidence of peri‐implant mucositis and peri‐implantitis was 25.3% and 3.7% at implant level and 30.3% and 6.6% at patient level, respectively. Conclusions Apart from the high success rate and healthy status of implant placed in staged SF seen, MBL alteration increased over time and was negatively affected predominately by patient‐specific risk factors such as smoking status and previous history of periodontitis.

Factors influencing the prevalence of peri‐implantitis in implants inserted in augmented maxillary sinuses: A multicenter cross‐sectional study

“…The prevalence of patients presenting peri‐implant pathologies was 19.9% (in detail, 10.9% mucositis and 9% peri‐implantitis) with a follow‐up ranging from 1 to 18 years after prosthetic loading (mean follow‐up, 4.6 years). Our findings are slightly higher in comparison with a recent prospective study analyzing implants placed in two‐stage maxillary sinus augmentation, reporting 6.6% patient‐level prevalence of peri‐implantitis 27 . This discrepancy could be likely due to different sample features between the two studies (e.g., 100% two‐stage sinus elevation versus 75% one‐stage).…”

Long‐term crestal bone changes in implants placed in augmented sinuses with minimal or moderate remaining alveolar bone: A 10‐year retrospective case‐series study

“…Result of linear regression models or simple logistics using generalized estimation equations (GEEs) or chi-square test of independence 16 mm 6 6 (100) 0 (0.0) a total of 7 implants (3.3% of implants) were diagnosed with PI. In a 5-year prospective study, Krennmair and coworkers reported almost the same results, with an implant-level rate of peri-implantitis of 3.3%, and 6.6% at the patient level (Krennmair et al, 2019).…”

Systematic review on diabetes mellitus and dental implants: an update

“…In fact, the conclusions on the influence of hyperglycemia on peri-implant inflammation are still heterogeneous. 12 clinical studies (1× cross-sectional study, 5× prospective, 6× retrospective) showed no increased risk of developing peri-implantitis with manifest diabetes mellitus [ 17 , 23 , 24 , 27 , 34 , 38 – 41 , 44 , 46 , 77 ]. On the other hand, six studies indicated an increased risk of peri-implant inflammation, with the highest determined relative risk being given as 8.65 [ 15 , 28 , 31 , 48 ].…”

“…The results regarding diabetes and implant survival are heterogeneous. Five studies showed no negative influence [ 10 , 11 , 38 , 42 , 44 ], two showed a non-significant [ 29 , 36 ] and six a significantly negative influence of diabetes on implant survival [ 12 , 16 , 32 , 37 ]. For example, the study of Alberti et al [ 38 ] showed no significant difference of the implant survival after 10 years in patients with diabetes (survival rate of 96.5%) compared to patients without diabetes mellitus (survival rate of 94.8%), whereas the study of French et al [ 37 ] identified diabetes mellitus with a hazard ratio of 2.25 as a risk factor for implant failure in a multivariate analysis, implicating an over two times higher risk for failure of dental implants in patients with diabetes mellitus.…”

“…In the evaluation, diabetics with an HbA1c < 7.5% were included and compared with non-diabetics. There was no difference in terms of bone augmentation, implant survival or peri-implant bone alteration [ 44 ]. A study on prediabetes and bone augmentation was not identified.…”