Implant maintenance treatment and peri-implant health

Abstract

Data sourcesMedline (PubMed), Embase, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases and a manual search of the Journal of Dental Research, Journal of Clinical Periodontology, Journal of Periodontology and the International Journal of Periodontics and Restorative Dentistry from January 2014 to February 2015.Study selectionProspective, retrospective, randomised or not, case-controlled or case series trials showing the incidence or recurrence of peri-implant disease plus or minus PIMT over more than six months.Data extraction and synthesisThree reviewers independently selected studies and abstracted data with two reviewers assessing study quality using the Newcastle-Ottawa Scale (NOS). A multivariate binomial regression was used to examine the data.ResultsThirteen studies were included with ten contributing to the meta-analysis. The average quality assessment score (NOS) was 5.3 out of a possible nine, only one paper achieved eight. At patient level mucositis ranged from 18.5-74.2% and peri-implantitis from 8-28%, with significant effects being seen for treatment (z= -14.36, p<0.001). Mucositis was affected by history of periodontitis and mean PIMT at implant and patient levels, respectively. For peri-implantitis there were also significant effects of treatment (z = -16.63, p<0.001). Increased peri-implantitis was observed for patients with a history of periodontal disease. (z=3.76, p<0.001). Implants under PIMT have 0.958 the incident event compared to those with no PIMT.ConclusionsWithin the limitations of the present systematic review it can be concluded that implant therapy must not be limited to placement and restoration of dental implants, but to the implementation of PIMT to potentially prevent biological complications and heighten the long-term success rate. Although it must be tailored to a patients risk profiling, our findings suggest reason to claim a minimum recall PIMT interval of five to six months. Additionally, it must be stressed that even in the establishment of PIMT, biological complications might occur. Hence, patient-, clinical-, and implant-related factors must be thoroughly explored.

Periodontal disease, peri-implant disease and levels of salivary biomarkers IL-1β, IL-10, RANK, OPG, MMP-2, TGF-β and TNF-α: follow-up over 5 years

“…The literature highlights that TMPP decreases biological complications and increases the success of long-term implants. 9 - 11 . In this sense, the objective of this study was to compare the salivary concentrations of interleukin (IL) IL-1β, IL-10, RANK, OPG, matrix metalloproteinase (MMP) MMP-2, transforming growth factor beta (TGF- β) and tumor necrosis factor alpha (TNF-α) immunological markers related to the peri-implantation condition of individuals with MP between baseline examination and final exam in the absence and presence of TMPP.…”

A Peri-Implant Disease Risk Score for Patients with Dental Implants: Validation and the Influence of the Interval between Maintenance Appointments

“…The modest impact of the recall regimen registered in the present study (an increase of less than 6%) on the excess risk for peri-implant disease is corroborated by the finding of Monje et al [12] and underlines the potential greater importance of each patients’ risk profile. A recent comment also highlighted this idea, stating that even when maintenance therapy is provided, biological complications can still occur and that maintenance therapy should be tailored to a patients’ risk profile [13]. For the avoidance of doubt, the result of the present study should not be interpreted as labeling the recall regimen irrelevant to the outcome.…”

“…In Dentistry, one prevention strategy in both Periodontal and Implant Dentistry is the recall regimen, accounting for patients’ signs and symptoms along with patient compliance and acceptance. Recall regimens are designed to help predict the long-term success of an outcome [9,10,11,12,13]. Specifically, a recall interval of five to six months has been proposed as the minimum required for successful outcomes in implant dentistry [12,13,14].…”

“…Recall regimens are designed to help predict the long-term success of an outcome [9,10,11,12,13]. Specifically, a recall interval of five to six months has been proposed as the minimum required for successful outcomes in implant dentistry [12,13,14]. The strength of this recommendation is based on a “D” classification—the lowest classification based on extrapolation from other categories of evidence, evidence from expert committee reports or opinions, clinical experience of respected authorities, or a combination of these categories [14].…”

Guided Bone Regeneration Using Collagen Scaffolds, Growth Factors, and Periodontal Ligament Stem Cells for Treatment of Peri-Implant Bone Defects In Vivo

“…Even despite adequate peri-implant maintenance therapy, some patients will develop these soft and hard tissue complications [ 8 ]. Untreated peri-implantitis is critical and may finally lead to loss of the affected implant [ 9 ]; therefore, an intervention should be carried out before substantial amounts of supporting bone are lost.…”