The impact of a change in classification criteria on the prevalence of peri‐implantitis: A cross‐sectional analysis

Abstract

Background Peri‐implantitis is a frequent finding but estimates of its prevalence vary widely. This may be due to the wide variety of disease definitions. In 2017 the World Workshop on Periodontal and Peri‐implant Diseases and Conditions established new criteria for disease definitions. The aim of this study is to assess the potential impact of a new definition on the future reporting of peri‐implant disease. Methods Data from a 2015 report of peri‐implant prevalence were examined using the new diagnostic criteria. This cross‐sectional study was performed on 95 patients with 220 implants who had their implants placed between 1998 and 2003. An examiner masked to the previous diagnosis examined the radiographs and patient data to make a diagnosis based on 3 mm of bone loss from the expected level of bone. This reanalysis was used to calculate the prevalence of peri‐implant disease and generate new relative risk indicators. Results The mean follow‐up time for the patients was 10.9 years. Using the 2017 criteria, peri‐implant mucositis was found in 35.3% of the implants and 52.2% of the subjects, and peri‐implantitis occurred in 8.7% of the implants and 15.2% of the subjects. This constituted a drop in peri‐implantitis at both patient and implant level of nearly 50% from the prior analysis. Smoking at time of implant placement emerged as a new risk factor in this analysis that was not identified in the prior analysis. Conclusions The new diagnostic criteria significantly reduce the reported prevalence of peri‐implantitis and bring new risk factors into focus.

Influence of Periodontitis, Implant, and Prosthesis Characteristics on the Peri-Implant Status: A Cross-Sectional Study

“…e same effect was seen in the study of Pimentel et al [32] for the impact of PPD ≥6 mm on peri-implantitis. In the study of Dalago et al [21], a history of periodontitis appeared to be a risk indicator of peri-implantitis only after multivariable analysis was conducted with an OR � 2.2. ese different observed associations may reflect the variability of clinical parameter interactions in the studied populations, as well as the use of different peri-implant disease definitions [47]. In the present study, peri-implant soft-tissue diseased sites defined as PiPD > 4 mm + BOPi remained independently associated to some demographic, periodontal, implant, and prosthesis parameters, suggesting that these parameters could influence periimplantitis triggering, as shown previously for other periodontal parameters in a similar cohort [28].…”

“…e number of implants was correlated with tooth loss, which could reflect the impact of periodontal risk indicators [24], as suggested for implant failure [46]. Using multivariable analysis, the impact of implant number on the peri-implant tissue parameters was reduced, as shown for peri-implantitis [31,47]. However, it was still present for Bli, suggesting that other risk factors specifically correlated with the implant number may influence peri-implant soft tissue conditions [23].…”

Peri-Implantitis Management: Surgical versus Non-Surgical Approach Using Photodynamic Therapy Combined with Hydrogen Peroxide (OHLLT—Oxygen High Level Laser Therapy): A Retrospective Controlled Study

“…A recent change in the classification of peri-implantitis has lead to an increased difficulty in the interpretation of the prevalence of this disease [2]. Nowadays, we can assume for peri-implantitis the presence of bleeding or suppuration with gentle pressure on probing and some variations from previous examinations, such as increased probing depth and increased bone loss; in the case of the absence of previous examinations, periimplantitis is defined as presence of bleeding and/or suppuration on gentle probing, probing depths ≥6 mm, and bone levels ≥3 mm apical to the most coronal portion of the intraosseous part of the implant, as stated by the American Academy of Periodontology and the European Federation of Periodontology [3].…”

Rough Dental Implant Surfaces and Peri-Implantitis: Role of Phase-Contrast Microscopy, Laser Protocols, and Modified Home Oral Hygiene in Maintenance. A 10-Year Retrospective Study

“…Moreover, it is very important to consider that different classifications, with restrictive diagnostic criteria, are associated with significantly reduced presence of peri-implantitis [5].…”

“…However, several authors have indicated that frequent patients recalls are involved in peri-implantitis prevention, and a close recall scheme is essential [2,[4][5][6].…”