Long‐term outcomes and prognostic factors of surgical treatment of peri‐implantitis – A retrospective study

Abstract

AimTo evaluate long‐term outcomes and prognostic factors of non‐reconstructive surgical treatment of peri‐implantitis.Materials and MethodsOne hundred forty‐nine patients (267 implants) were surgically treated for peri‐implantitis and followed for an average of 7.0 (SD: 3.6) years. The primary outcome was implant loss. Additional bone loss and surgical retreatment were secondary outcomes. Patient/implant characteristics, as well as clinical and radiographic parameters collected prior to initial surgery, were evaluated as potential predictors of implant loss. Flexible parametric survival models using restricted cubic spline functions were used; 5‐ and 10‐year predicted rates of implant loss were calculated according to different scenarios.ResultsFifty‐three implants (19.9%) in 35 patients (23.5%) were lost during the observation period. Implant loss occurred after a mean period of 4.4 (SD: 3.0) years and was predicted by implant surface characteristics (modified surface; HR 4.5), implant length (HR 0.8 by mm), suppuration at baseline (HR 2.7) and disease severity (baseline bone loss: HR 1.2 by mm). Estimates of 5‐ and 10‐year implant loss ranged from 1% (best prognostic scenario; initial bone loss <40% of implant length, turned implant surface and absence of suppuration on probing (SoP)) to 63% (worst prognostic scenario; initial bone loss ≥60% of implant length, modified implant surface and SoP) and from 3% to 89%, respectively. Surgical retreatment was performed at 65 implants (24.3%) in 36 patients (24.2%) after a mean time period of 4.5 (3.1) years. In all, 59.5% of implants showed additional bone loss, were surgically retreated or lost.ConclusionsRecurrence of disease is common following surgical treatment of peri‐implantitis. The strongest predictor for implant loss was implant surface characteristics. Implant length as well as suppuration and disease severity at baseline were also relevant factors.

Microbiota associated with peri‐implantitis—A systematic review with meta‐analyses

“…In light of its high prevalence (Derks et al, 2016;Romandini et al, 2019;Romandini et al, 2021a), poor prognosis (Berglundh, Wennström, & Lindhe, 2018;Romandini et al, 2023), and limited efficacy of current treatment approaches (Baima et al, 2022;Derks et al, 2022;Regidor et al, 2023;Romandini et al, 2022), prevention and early diagnosis are of critical importance in the management of peri-implantitis. Due to the lack of specific symptoms associated with peri-implantitis, the two key elements for its early diagnosis are the availability of baseline documentation to assess early changes in radiographic bone levels and tight screening for disease occurrence during recalls (supportive peri-implant care) (Berglundh et al, 2021;Romandini et al, 2021b;Romandini et al, 2021c).…”