Prevalence and risk/protective indicators of peri-implant diseases: a university-representative cross-sectional study

J Clinic Periodontology

Pedrinaci

Lima

et al. 2021

Self Cite

Aim To evaluate the prevalence of buccal peri‐implant soft tissue dehiscence (PISTD) in anterior implants and to identify the risk/protective indicators of PISTD in implants not suffering peri‐implantitis. Materials and methods 240 randomly selected patients from a university clinic database were invited to participate in the present cross‐sectional study. Those who accepted, after the evaluation of their medical and dental records, were clinically examined to assess the prevalence of buccal PISTD in non‐molar implants. Multilevel multivariate logistic regression analyses were then carried out to identify those factors associated either positively (risk) or negatively (protective) with buccal PISTD in implants without peri‐implantitis. Results 92 patients with a total of 272 dental implants were analysed. At implant‐level, the prevalence of buccal PISTD was 16.9%, while when selecting only implants without peri‐implantitis it was 12.0%. Buccal PISTD was present in 26.7% of the implants diagnosed with peri‐implantitis. The following factors were identified as risk/protective indicators of buccal PISTD in implants without peri‐implantitis: malposition (too buccal vs. correct: OR=14.67), thin peri‐implant phenotype (OR=8.31), presence of at least one adjacent tooth (OR=0.08) and presence of abutment (OR=0.12). Conclusions PISTD are highly prevalent among patients with dental implants in this university‐based population, and several factors were identified as risk and protective indicators of PISTD in implants not suffering peri‐implantitis.

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence and risk/protective indicators of buccal soft tissue dehiscence around dental implants

J Clinic Periodontology

Pedrinaci

Lima

et al. 2021

Self Cite

“…Peri‐implantitis is a plaque‐associated pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri‐implant mucosa and subsequent progressive loss of supporting bone (Berglundh et al., 2018; Schwarz et al., 2018). Studies have shown that the prevalence of peri‐implantitis ranges from 10% to 40% depending on case definitions (Derks, Schaller, Hakansson, et al, 2016; Rodrigo et al., 2018; Romandini et al, 2019, 2020b; Vignoletti et al., 2019; Wada et al., 2019) and that the progression of the disease follows a non‐linear and accelerating pattern and may result in implant loss (Derks, Schaller, Håkansson, et al, 2016; Karlsson et al., 2019).…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of peri‐implantitis in the absence of baseline data: A diagnostic accuracy study

Clinical Oral Implants Res

Berglundh

Derks

et al. 2021

Self Cite

Objectives The aim of the present study was to evaluate the diagnostic accuracy of clinical and radiographic evaluations made at a single time point during follow‐up in identifying (a) a history of peri‐implant bone loss and (b) the presence of peri‐implantitis. Material & Methods 427 patients provided with implant‐supported reconstructions 9 years earlier were evaluated clinically by Probing Pocket Depth, Bleeding or Suppuration on Probing (PPD, BoP & SoP) and radiographically. Bone levels were assessed relative to the most coronal point of the intra‐osseous part of the implant. A history of bone loss and diagnosis of peri‐implantitis was confirmed through baseline documentation (direct evidence). Diagnostic accuracy of radiographic bone levels at 9 years and clinical findings (indirect evidence/secondary case definition) in identifying a history of bone loss and peri‐implantitis were evaluated through correlation and multilevel regression analyses as well as receiver operating characteristic curves. Results were expressed as sensitivity/specificity and area under the curve (AUC). Results Bone levels observed at 9 years were highly accurate in identifying pronounced bone loss (>2 mm; AUC = 0.96; 95% CI 0.95–0.98). In the absence of baseline documentation, a secondary case definition based on the presence of BoP/SoP & bone level ≥ 1 mm (indirect evidence) provided the overall best diagnostic accuracy (AUC = 0.80; 95% CI 0.77–0.82) in identifying peri‐implantitis cases (direct evidence: BoP/SoP & bone loss > 0.5 mm). Moderate/severe peri‐implantitis (BoP/SoP & bone loss > 2 mm) was most accurately identified by the combination of BoP/SoP & bone level ≥ 2 mm (AUC = 0.93; 95% CI 0.91–0.96). Sensitivity of the secondary case definition suggested by the 2017 World Workshop of Periodontology (WWP) (BoP/SoP ≥ 1 site & bone level ≥ 3 mm & PPD ≥ 6 mm) was low. Conclusions The present results underline the importance of baseline documentation for the correct diagnosis of peri‐implantitis, especially in its early/incipient forms. The secondary case definition of peri‐implantitis suggested at the 2017 WWP demonstrated a high level of specificity but low sensitivity. Moderate/severe peri‐implantitis was most accurately identified by the combination of BoP/SoP & bone level ≥ 2 mm.

“…peri-implant mucositis), when their control is easier. However, the actual patient compliance to maintenance recalls is generally low (Amerio et al, 2020; Romandini et al, 2020). In this context, the presence of symptoms could potentially alert patients with peri-implant diseases to seek dental care before the disease is too advanced.…”

Section: Introductionmentioning

confidence: 99%

Clinical signs, symptoms, perceptions and impact on quality of life of patients suffering peri-implant diseases: a university-representative cross-sectional study

Lima

Pedrinaci

et al. 2020

Preprint

Self Cite

Aim: To study the symptoms and perception reported by patients with peri-implant diseases, as well as their signs and their potential impact on the oral health quality of life. Materials and Methods: 240 randomly selected patients were invited to participate. As part of the history assessment, the patient OHIP-14Sp was evaluated together with, for each implant, the patient perception regarding the peri-implant health status and the history of pain, spontaneous discomfort, bleeding, suppuration, swelling and discomfort during brushing. As part of the clinical examination, the following potential signs of peri-implant diseases were collected: probing pocket depth (PPD), mucosal dehiscence (MD), extent of BoP, presence of SoP, and visual signs of redness and swelling. Those parameters were analyzed in relation to the actual peri-implant health diagnosis. Results: 99 patients with a total of 458 dental implants were studied. Even in case of peri-implantitis, 88.89% of the implants were perceived by the patients as healthy. The total OHIP-14Sp sum score did not differ in relation to the peri-implant health diagnosis. Increased reports of spontaneous discomfort, bleeding, swelling and discomfort during brushing were observed in presence of disease. However, only a minor proportion of implants with peri-implant diseases presented symptoms. PPD≥6 mm was more frequent in diseased than in healthy implants (p<0.01), while PPD≥8 in pre-periimplantitis/peri-implantitis than in healthy/mucositis implants (p<0.01). Implants with peri-implantitis showed higher MD than implants without peri-implantitis (p<0.01). Conclusions: Peri-implant diseases are in most cases asymptomatic and not perceived by the patients. Despite being unable to accurately discriminate between peri-implant mucositis and peri-implantitis, PPD and MD resulted as the only two clinical signs associated with pre-periimplantitis/peri-implantitis.