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Risk indicators associated with peri-implant diseases: a retrospective cross-sectional study of Colombian patients with 1 to 18 years of follow-up

  • Received : 2022.12.15
  • Accepted : 2023.06.04
  • Published : 2024.06.30

Abstract

Purpose: Peri-implant mucositis (PIM) and peri-implantitis (PI) are multicausal conditions with several risk factors contributing to their pathogenesis. In this study, we retrospectively investigated risk variables potentially associated with these peri-implant diseases (PIDs) over a follow-up period of 1 to 18 years. Methods: The study sample consisted of 379 implants placed in 155 patients. Single-visit clinical and radiographic evaluations were employed to determine the presence or absence of PIDs. Parameters related to the patient, site, surgery, implant, and prosthetic restoration were documented. The relationships between risk variables and the occurrence of PIDs were individually examined and adjusted for confounders using multivariate binary logistic regression models. Results: The prevalence rates of PIM and PI were 28.4% and 36.8% at the patient level and 33.5% and 24.5% at the implant level, respectively. Poor oral hygiene, active gingivitis/periodontitis, preoperative alveolar ridge deficiency, early or delayed implant placement, implant length of 11.0 mm or less, and poor restoration quality were strong and independent risk indicators for both PIDs. Furthermore, a follow-up period of more than 5 years and a loading time of more than 4 years were important indicators for PI. Simultaneously, age and smoking status acted as modifiers of the effect of mesiodistal (MD) and buccolingual (BL) widths of restoration on PI. Conclusions: In this study population, oral hygiene, periodontal status, preoperative alveolar ridge status, implant placement protocol, implant length, and the quality of coronal restoration appear to be robust risk indicators for both PIM and PI. Additionally, the length of follow-up and functional loading time are robust indicators of PI. Furthermore, the potential modifying relationships of age and smoking status with the MD and BL widths of restoration may be crucial for the development of PI.

Keywords

Acknowledgement

The study received full funding from the Technical Research Council of the Faculty of Dentistry of the University of Antioquia (reference No. 2019-25776) and the University Health Care Provider (reference No. IN30-2019).

References

  1. Renvert S, Persson GR, Pirih FQ, Camargo PM. Peri-implant health, peri-implant mucositis, and peri-implantitis: case definitions and diagnostic considerations. J Periodontol 2018;89 Suppl 1:S304-12. https://doi.org/10.1002/JPER.17-0588
  2. Pimentel SP, Shiota R, Cirano FR, Casarin RCV, Pecorari VGA, Casati MZ, et al. Occurrence of peri-implant diseases and risk indicators at the patient and implant levels: a multilevel cross-sectional study. J Periodontol 2018;89:1091-100. https://doi.org/10.1002/JPER.17-0599
  3. Heitz-Mayfield LJ. Peri-implant diseases: diagnosis and risk indicators. J Clin Periodontol 2008;35:292-304. https://doi.org/10.1111/j.1600-051X.2008.01275.x
  4. Dalago HR, Schuldt Filho G, Rodrigues MA, Renvert S, Bianchini MA. Risk indicators for peri-implantitis. a cross-sectional study with 916 implants. Clin Oral Implants Res 2017;28:144-50. https://doi.org/10.1111/clr.12772
  5. Kumar PS, Dabdoub SM, Hegde R, Ranganathan N, Mariotti A. Site-level risk predictors of peri-implantitis: a retrospective analysis. J Clin Periodontol 2018;45:597-604. https://doi.org/10.1111/jcpe.12892
  6. Maximo MB, de Mendonca AC, Alves JF, Cortelli SC, Peruzzo DC, Duarte PM. Peri-implant diseases may be associated with increased time loading and generalized periodontal bone loss: preliminary results. J Oral Implantol 2008;34:268-73. https://doi.org/10.1563/1548-1336(2008)34[269:PDMBAW]2.0.CO;2
  7. Atieh MA, Alsabeeha NH, Faggion CM Jr, Duncan WJ. The frequency of peri-implant diseases: a systematic review and meta-analysis. J Periodontol 2013;84:1586-98. https://doi.org/10.1902/jop.2012.120592
  8. Daubert DM, Weinstein BF, Bordin S, Leroux BG, Flemming TF. Prevalence and predictive factors for peri-implant disease and implant failure: a cross-sectional analysis. J Periodontol 2015;86:337-47. https://doi.org/10.1902/jop.2014.140438
  9. Wada M, Mameno T, Onodera Y, Matsuda H, Daimon K, Ikebe K. Prevalence of peri-implant disease and risk indicators in a Japanese population with at least 3 years in function - a multicentre retrospective study. Clin Oral Implants Res 2019;30:111-20. https://doi.org/10.1111/clr.13397
  10. Kissa J, El Kholti W, Chemlali S, Kawtari H, Laalou Y, Albandar JM. Prevalence and risk indicators of peri-implant diseases in a group of Moroccan patients. J Periodontol 2021;92:1096-106. https://doi.org/10.1002/JPER.20-0549
  11. Kordbacheh Changi K, Finkelstein J, Papapanou PN. Peri-implantitis prevalence, incidence rate, and risk factors: a study of electronic health records at a U.S. dental school. Clin Oral Implants Res 2019;30:306-14. https://doi.org/10.1111/clr.13416
  12. Derks J, Tomasi C. Peri-implant health and disease. A systematic review of current epidemiology. J Clin Periodontol 2015;42 Suppl 16:S158-71. https://doi.org/10.1111/jcpe.12334
  13. Lee CT, Huang YW, Zhu L, Weltman R. Prevalences of peri-implantitis and peri-implant mucositis: systematic review and meta-analysis. J Dent 2017;62:1-12. https://doi.org/10.1016/j.jdent.2017.04.011
  14. Monje A, Wang HL, Nart J. Association of preventive maintenance therapy compliance and peri-implant diseases: a cross-sectional study. J Periodontol 2017;88:1030-41. https://doi.org/10.1902/jop.2017.170135
  15. Berglundh T, Wennstrom JL, Lindhe J. Long-term outcome of surgical treatment of peri-implantitis. A 2-11-year retrospective study. Clin Oral Implants Res 2018;29:404-10. https://doi.org/10.1111/clr.13138
  16. Gothberg C, Grondahl K, Omar O, Thomsen P, Slotte C. Bone and soft tissue outcomes, risk factors, and complications of implant-supported prostheses: 5-years RCT with different abutment types and loading protocols. Clin Implant Dent Relat Res 2018;20:313-21. https://doi.org/10.1111/cid.12587
  17. Engebretson SP, Grbic JT, Singer R, Lamster IB. GCF IL-1beta profiles in periodontal disease. J Clin Periodontol 2002;29:48-53.
  18. Ahlner F, Falk Erhag H, Johansson L, Mellqvist Fassberg M, Rydberg Sterner T, Samuelsson J, et al. Patterns of alcohol consumption and associated factors in a population-based sample of 70-year-olds: data from the Gothenburg H70 Birth Cohort Study 2014-16. Int J Environ Res Public Health 2022;19:8248.
  19. Wang HL, Al-Shammari K. HVC ridge deficiency classification: a therapeutically oriented classification. Int J Periodontics Restorative Dent 2002;22:335-43.
  20. Gallucci GO, Hamilton A, Zhou W, Buser D, Chen S. Implant placement and loading protocols in partially edentulous patients: a systematic review. Clin Oral Implants Res 2018;29 Suppl 16:106-34. https://doi.org/10.1111/clr.13276
  21. Katafuchi M, Weinstein BF, Leroux BG, Chen YW, Daubert DM. Restoration contour is a risk indicator for peri-implantitis: a cross-sectional radiographic analysis. J Clin Periodontol 2018;45:225-32. https://doi.org/10.1111/jcpe.12829
  22. Chapple IL, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2018;89 Suppl 1:S74-84.
  23. Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, et al. Periodontitis: consensus report of workgroup 2 of the 2017 World Workshop on the classification of periodontal and peri-Implant diseases and conditions. J Periodontol 2018;89 Suppl 1:S173-82.
  24. Heitz-Mayfield LJ, Heitz F, Lang NP. Implant Disease Risk Assessment IDRA-a tool for preventing peri-implant disease. Clin Oral Implants Res 2020;31:397-403. https://doi.org/10.1111/clr.13585
  25. Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, et al. Peri-implant diseases and conditions: consensus report of workgroup 4 of the 2017 World Workshop on the classification of periodontal and peri-implant diseases and conditions. J Periodontol 2018;89 Suppl 1:S313-8. https://doi.org/10.1002/JPER.17-0739
  26. Schwarz F, Alcoforado G, Guerrero A, Jonsson D, Klinge B, Lang N, et al. Peri-implantitis: summary and consensus statements of group 3. The 6th EAO Consensus Conference 2021. Clin Oral Implants Res 2021;32 Suppl 21:245-53. https://doi.org/10.1111/clr.13827
  27. Lang NP, Bosshardt DD, Lulic M. Do mucositis lesions around implants differ from gingivitis lesions around teeth? J Clin Periodontol 2011;38 Suppl 11:182-7. https://doi.org/10.1111/j.1600-051X.2010.01667.x
  28. Dabdoub SM, Tsigarida AA, Kumar PS. Patient-specific analysis of periodontal and peri-implant microbiomes. J Dent Res 2013;92:168S-75S. https://doi.org/10.1177/0022034513504950
  29. Monje A, Galindo-Moreno P, Tozum TF, Suarez-Lopez del Amo F, Wang HL. Into the paradigm of local factors as contributors for peri-implant disease: short communication. Int J Oral Maxillofac Implants 2016;31:288-92. https://doi.org/10.11607/jomi.4265
  30. Krennmair S, Hunger S, Forstner T, Malek M, Krennmair G, Stimmelmayr M. Implant health and factors affecting peri-implant marginal bone alteration for implants placed in staged maxillary sinus augmentation: a 5-year prospective study. Clin Implant Dent Relat Res 2019;21:32-41. https://doi.org/10.1111/cid.12684
  31. Bassetti M, Kaufmann R, Salvi GE, Sculean A, Bassetti R. Soft tissue grafting to improve the attached mucosa at dental implants: a review of the literature and proposal of a decision tree. Quintessence Int 2015;46:499-510.
  32. Parvini P, Obreja K, Becker K, Galarraga ME, Schwarz F, Ramanauskaite A. The prevalence of peri-implant disease following immediate implant placement and loading: a cross-sectional analysis after 2 to 10 years. Int J Implant Dent 2020;6:63.
  33. Bianchi AE, Sanfilippo F. Single-tooth replacement by immediate implant and connective tissue graft: a 1-9-year clinical evaluation. Clin Oral Implants Res 2004;15:269-77. https://doi.org/10.1111/j.1600-0501.2004.01020.x
  34. Schropp L, Wenzel A, Stavropoulos A. Early, delayed, or late single implant placement: 10-year results from a randomized controlled clinical trial. Clin Oral Implants Res 2014;25:1359-65. https://doi.org/10.1111/clr.12273
  35. Kim YM, Lee JB, Um HS, Chang BS, Lee JK. Long-term effect of implant-abutment connection type on marginal bone loss and survival of dental implants. J Periodontal Implant Sci 2022;52:496-508. https://doi.org/10.5051/jpis.2200960048
  36. Manzano G, Montero J, Martin-Vallejo J, Del Fabbro M, Bravo M, Testori T. Risk factors in early implant failure: a meta-analysis. Implant Dent 2016;25:272-80. https://doi.org/10.1097/ID.0000000000000386
  37. Bataineh AB, Al-Dakes AM. The influence of length of implant on primary stability: an in vitro study using resonance frequency analysis. J Clin Exp Dent 2017;9:e1-6. https://doi.org/10.4317/jced.53302
  38. Robau-Porrua A, Perez-Rodriguez Y, Soris-Rodriguez LM, Perez-Acosta O, Gonzalez JE. The effect of diameter, length and elastic modulus of a dental implant on stress and strain levels in peri-implant bone: a 3D finite element analysis. Biomed Mater Eng 2020;30:541-58. https://doi.org/10.3233/BME-191073
  39. Rokaya D, Srimaneepong V, Wisitrasameewon W, Humagain M, Thunyakitpisal P. Peri-implantitis update: risk indicators, diagnosis, and treatment. Eur J Dent 2020;14:672-82. https://doi.org/10.1055/s-0040-1715779
  40. Urdaneta RA, Rodriguez S, McNeil DC, Weed M, Chuang SK. The effect of increased crown-to-implant ratio on single-tooth locking-taper implants. Int J Oral Maxillofac Implants 2010;25:729-43.