The Crucial Role of Plaque Control in Peri-Implant Mucositis Initiation as Opposed to the Role of Systemic Health Condition: A Cross-Sectional Study

Abstract

Purpose The aim of this study was to investigate the priority of periodontal plaque as a risk factor compared to other risk factors, namely hypertension and diabetes mellitus type II, regarding the initiation and severity of peri-implant mucositis, eventually reinforcing the importance of plaque control, periodic maintenance and supportive periodontic treatment after implant placement in order to prevent peri-implant diseases. Patients and Methods A total of 58 patients (84 implants) were enrolled; each individual implant was considered as a separate sample first, then sampling by patient was also applied, implants were divided into group A: systemically healthy patients and B: patients with hypertension and diabetes mellitus type II, the status of peri-implant tissue was followed after the healing abutment placement, with regard to implant mucosal index (IMI), probing pocket depth (PPD) and bleeding on probing (BOP); when sampling was done by patient, the mean of scores of all examined implants in each patient was taken to represent one sample. Results Group A implants showed higher mean scores of PPD (5.2 mm) than group B (4.2 mm) with significance (P = 0.014), and higher mean scores of BOP, group A = 0.71, group B = 0.45 with (P = 0.015); there was no statistical difference with regard to IMI, group A = 1.35, group B = 1.16 with (P = 0.172). Similar results were obtained when the sampling was calculated by patient; PPD: group A (5.31 mm), group B (4.75 mm) and P = 0.008, IMI: group A (1.34), group B (1.16) and P = 0.131, BOP: group A (0.75), group B (0.48) and P = 0.03. Conclusion In the absence of proper plaque control, systemic diseases showed no impact on the initiation and severity of peri-implant mucositis when compared to systemically healthy patients.

Dental implant considerations in patients with systemic diseases: An updated comprehensive review

“…Patients with hypertension are more likely to experience attachment loss and severe gingivitis because of a heightened immunological response. In patients with hypertension and those with coronary heart disease, inflammatory mediators like interleukins, c‐reactive proteins, tumour necrosis factor and metalloprotease are released, leading to a triggered immune response 24 …”

“…In patients with hypertension and those with coronary heart disease, inflammatory mediators like interleukins, c-reactive proteins, tumour necrosis factor and metalloprotease are released, leading to a triggered immune response. 24 In general, antihypertensive prescriptions help in bone generation and a lesser risk of bone fractures. 25 According to a study by Seki et al, antihypertensive medicines adversely affect dental implants.…”

Systemic Diseases and Biological Dental Implant Complications: A Narrative Review

“…In all, 51 studies were identified concerning the influence of prediabetes and diabetes mellitus type I or II on the onset of late complications in dental implants: 14 were prospective [15][16][17][18][19][20][21][22][23][24][25][26][27][28]; 23 retrospective ; 10 cross-sectional [52][53][54][55][56][57][58][59][60][61] and 5 of unspecified design [62][63][64][65][66]. Thirty-three of these studies found no association between the success or failure of dental implants and diabetes, while seventeen reported a positive correlation, and in one (cross-sectional) study the peri-implant inflammation parameters were better in patients with diabetes and hypertension than in healthy individuals [53] Articles were grouped by findings concerning diabetes as a risk factor for biological complications of dental implants (Table 1). Four of the fifty-one studies [31,52,58,59] identified prediabetes as a risk factor for periimplant inflammation.…”

“…The seven studies identified (four retrospective and three cross-sectional) were almost unanimous in finding no evidence of hypertension being a risk factor for dental implant rehabilitation [44,46,47,53,54,57]. The only exception was one study reporting a higher rate of implant failure in hypertensive patients [48].…”

“…Only one study identified higher rates of implant failure in patients with hypertension [48], though the difference was only statistically significant for individuals who were also smokers. AbdulAzeez et al [53] reported that, in the absence of an adequate monitoring of oral hygiene, systemic diseases had no impact on the severity of bleeding on probing or the probing depth. In fact, the healthy people in their sample revealed more severe inflammation in the oral cavity than patients suffering from diabetes or hypertension.…”