DOI QR코드

DOI QR Code

Risk indicators for mucositis and peri-implantitis: results from a practice-based cross-sectional study

  • Rinke, Sven (Department of Prosthodontics, University Medical Center Goettingen) ;
  • Nordlohne, Marc ;
  • Leha, Andreas (Department of Medical Statistics, Georg-August-University) ;
  • Renvert, Stefan (School of Health and Society, Kristianstad University) ;
  • Schmalz, Gerhard (Department of Cariology, Endodontology and Periodontology, University Leipzig) ;
  • Ziebolz, Dirk (Department of Cariology, Endodontology and Periodontology, University Leipzig)
  • Received : 2019.09.18
  • Accepted : 2020.04.01
  • Published : 2020.06.30

Abstract

Purpose: This practice-based cross-sectional study aimed to investigate whether common risk indicators for peri-implant diseases were associated with peri-implant mucositis and peri-implantitis in patients undergoing supportive implant therapy (SIT) at least 5 years after implant restoration. Methods: Patients exclusively restored with a single implant type were included. Probing pocket depth (PPD), bleeding on probing (BOP), suppuration, and radiographic bone loss (RBL) were assessed around implants. The case definitions were as follows: peri-implant mucositis: PPD ≥4 mm, BOP, no RBL; and peri-implantitis: PPD ≥5 mm, BOP, RBL ≥3.5 mm. Possible risk indicators were compared between patients with and without mucositis and peri-implantitis using the Fisher exact test and the Wilcoxon rank-sum test, as well as a multiple logistic regression model for variables showing significance (P<0.05). Results: Eighty-four patients with 169 implants (observational period: 5.8±0.86 years) were included. A patient-based prevalence of 52% for peri-implant mucositis and 18% for peri-implantitis was detected. The presence of 3 or more implants (odds ratio [OR], 4.43; 95 confidence interval [CI], 1.36-15.05; P=0.0136) was significantly associated with an increased risk for mucositis. Smoking was significantly associated with an increased risk for peri-implantitis (OR, 5.89; 95% CI, 1.27-24.58; P=0.0231), while the presence of keratinized mucosa around implants was associated with a lower risk for peri-implantitis (OR, 0.05; 95% CI, 0.01-0.25; P<0.001). Conclusions: The number of implants should be considered in strategies to prevent mucositis. Furthermore, smoking and the absence of keratinized mucosa were the strongest risk indicators for peri-implantitis in patients undergoing SIT in the present study.

Keywords

References

  1. Lang NP, Berglundh TWorking Group 4 of Seventh European Workshop on Periodontology. Periimplant diseases: where are we now?--Consensus of the Seventh European Workshop on Periodontology. J Clin Periodontol 2011;38 Suppl 11:178-81. https://doi.org/10.1111/j.1600-051X.2010.01674.x
  2. 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
  3. Monje A, Aranda L, Diaz KT, Alarcon MA, Bagramian RA, Wang HL, et al. Impact of maintenance therapy for the prevention of peri-implant diseases: a systematic review and meta-analysis. J Dent Res 2016;95:372-9. https://doi.org/10.1177/0022034515622432
  4. Smeets R, Henningsen A, Jung O, Heiland M, Hammacher C, Stein JM. Definition, etiology, prevention and treatment of peri-implantitis--a review. Head Face Med 2014;10:34. https://doi.org/10.1186/1746-160X-10-34
  5. Alani A, Bishop K. Peri-implantitis. Part 2: prevention and maintenance of peri-implant health. Br Dent J 2014;217:289-97. https://doi.org/10.1038/sj.bdj.2014.809
  6. Schwendicke F, Tu YK, Stolpe M. Preventing and treating peri-implantitis: a cost-effectiveness analysis. J Periodontol 2015;86:1020-9. https://doi.org/10.1902/jop.2015.150071
  7. Costa FO, Takenaka-Martinez S, Cota LO, Ferreira SD, Silva GL, Costa JE. Peri-implant disease in subjects with and without preventive maintenance: a 5-year follow-up. J Clin Periodontol 2012;39:173-81. https://doi.org/10.1111/j.1600-051X.2011.01819.x
  8. Sgolastra F, Petrucci A, Severino M, Gatto R, Monaco A. Smoking and the risk of peri-implantitis. A systematic review and meta-analysis. Clin Oral Implants Res 2015;26:e62-7. https://doi.org/10.1111/clr.12333
  9. Stacchi C, Berton F, Perinetti G, Frassetto A, Lombardi T, Khoury A, et al. Risk factors for peri-implantitis: effect of history of periodontal disease and smoking habits. a systematic review and meta-analysis. J Oral Maxillofac Res 2016;7:e3.
  10. Renvert S, Polyzois I. Risk indicators for peri-implant mucositis: a systematic literature review. J Clin Periodontol 2015;42 Suppl 16:S172-86. https://doi.org/10.1111/jcpe.12346
  11. Saaby M, Karring E, Schou S, Isidor F. Factors influencing severity of peri-implantitis. Clin Oral Implants Res 2016;27:7-12. https://doi.org/10.1111/clr.6_12957
  12. 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.
  13. Rinke S, Ohl S, Ziebolz D, Lange K, Eickholz P. Prevalence of periimplant disease in partially edentulous patients: a practice-based cross-sectional study. Clin Oral Implants Res 2011;22:826-33. https://doi.org/10.1111/j.1600-0501.2010.02061.x
  14. Landry RG, Jean M. Periodontal screening and recording (PSR) index: precursors, utility and limitations in a clinical setting. Int Dent J 2002;52:35-40. https://doi.org/10.1111/j.1875-595X.2002.tb00595.x
  15. Roos-Jansaker AM, Lindahl C, Renvert H, Renvert S. Nine- to fourteen-year follow-up of implant treatment. Part I: implant loss and associations to various factors. J Clin Periodontol 2006a;33:283-9. https://doi.org/10.1111/j.1600-051X.2006.00907.x
  16. Karoussis IK, Muller S, Salvi GE, Heitz-Mayfield LJ, Bragger U, Lang NP. Association between periodontal and peri-implant conditions: a 10-year prospective study. Clin Oral Implants Res 2004;15:1-7. https://doi.org/10.1111/j.1600-0501.2004.00982.x
  17. Roos-Jansaker AM, Lindahl C, Renvert H, Renvert S. Nine- to fourteen-year follow-up of implant treatment. Part II: presence of peri-implant lesions. J Clin Periodontol 2006b;33:290-5. https://doi.org/10.1111/j.1600-051X.2006.00906.x
  18. Renvert S, Persson GR, Pirih FQ, Camargo PM. Peri-implant health, peri-implant mucositis, and peri-implantitis: case definitions and diagnostic considerations. J Clin Periodontol 2018;45 Suppl 20:S278-85. https://doi.org/10.1111/jcpe.12956
  19. Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J 1975;25:229-35.
  20. O'Leary TJ, Drake RB, Naylor JE. The plaque control record. J Periodontol 1972;43:38. https://doi.org/10.1902/jop.1972.43.1.38
  21. Eickholz P, Kaltschmitt J, Berbig J, Reitmeir P, Pretzl B. Tooth loss after active periodontal therapy. 1: patient-related factors for risk, prognosis, and quality of outcome. J Clin Periodontol 2008;35:165-74. https://doi.org/10.1111/j.1600-051X.2007.01184.x
  22. 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.
  23. Derks J, Schaller D, Hakansson J, Wennstrom JL, Tomasi C, Berglundh T. Effectiveness of implant therapy analyzed in a Swedish population: prevalence of peri-implantitis. J Dent Res 2016;95:43-9. https://doi.org/10.1177/0022034515608832
  24. 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
  25. Rakic M, Galindo-Moreno P, Monje A, Radovanovic S, Wang HL, Cochran D, et al. How frequent does peri-implantitis occur? A systematic review and meta-analysis. Clin Oral Investig 2018;22:1805-16. https://doi.org/10.1007/s00784-017-2276-y
  26. Mir-Mari J, Mir-Orfila P, Figueiredo R, Valmaseda-Castellon E, Gay-Escoda C. Prevalence of peri-implant diseases. A cross-sectional study based on a private practice environment. J Clin Periodontol 2012;39:490-4. https://doi.org/10.1111/j.1600-051X.2012.01872.x
  27. Frisch E, Ziebolz D, Rinke S. Long-term results of implant-supported over-dentures retained by double crowns: a practice-based retrospective study after minimally 10 years follow-up. Clin Oral Implants Res 2013;24:1281-7. https://doi.org/10.1111/j.1600-0501.2012.02568.x
  28. Salvi GE, Zitzmann NU. The effects of anti-infective preventive measures on the occurrence of biologic implant complications and implant loss: a systematic review. Int J Oral Maxillofac Implants 2014;29 Suppl:292-307. https://doi.org/10.11607/jomi.2014suppl.g5.1
  29. Passoni BB, Dalago HR, Schuldt Filho G, Oliveira de Souza JG, Benfatti CA, Magini RS, et al. Does the number of implants have any relation with peri-implant disease? J Appl Oral Sci 2014;22:403-8. https://doi.org/10.1590/1678-775720140055
  30. Gurgel BC, Montenegro SC, Dantas PM, Pascoal AL, Lima KC, Calderon PD. Frequency of peri-implant diseases and associated factors. Clin Oral Implants Res 2017;28:1211-7. https://doi.org/10.1111/clr.12944
  31. Serino G, Strom C. Peri-implantitis in partially edentulous patients: association with inadequate plaque control. Clin Oral Implants Res 2009;20:169-74. https://doi.org/10.1111/j.1600-0501.2008.01627.x
  32. Konstantinidis IK, Kotsakis GA, Gerdes S, Walter MH. Cross-sectional study on the prevalence and risk indicators of peri-implant diseases. Eur J Oral Implantology 2015;8:75-88.
  33. Dreyer H, Grischke J, Tiede C, Eberhard J, Schweitzer A, Toikkanen SE, et al. Epidemiology and risk factors of peri-implantitis: a systematic review. J Periodontal Res 2018;53:657-81. https://doi.org/10.1111/jre.12562
  34. Canullo L, Penarrocha-Oltra D, Covani U, Botticelli D, Serino G, Penarrocha M. Clinical and microbiological findings in patients with peri-implantitis: a cross-sectional study. Clin Oral Implants Res 2016;27:376-82.
  35. Ferreira CF, Buttendorf AR, de Souza JG, Dalago H, Guenther SF, Bianchini MA. Prevalence of peri-implant diseases: analyses of associated factors. Eur J Prosthodont Restor Dent 2015;23:199-206.
  36. Rokn A, Aslroosta H, Akbari S, Najafi H, Zayeri F, Hashemi K. Prevalence of peri-implantitis in patients not participating in well-designed supportive periodontal treatments: a cross-sectional study. Clin Oral Implants Res 2017;28:314-9.
  37. Grischke J, Karch A, Wenzlaff A, Foitzik MM, Stiesch M, Eberhard J. Keratinized mucosa width is associated with severity of peri-implant mucositis. A cross-sectional study. Clin Oral Implants Res 2019;30:457-65. https://doi.org/10.1111/clr.412_13509
  38. Pranskunas M, Poskevicius L, Juodzbalys G, Kubilius R, Jimbo R. Influence of peri-implant soft tissue condition and plaque accumulation on peri-implantitis: a systematic review. J Oral Maxillofac Res 2016;7:e2.
  39. Carcuac O, Jansson L. Peri-implantitis in a specialist clinic of periodontology. Clinical features and risk indicators. Swed Dent J 2010;34:53-61.
  40. Ziebolz D, Schmalz G, Gollasch D, Eickholz P, Rinke S. Microbiological and aMMP-8 findings depending on peri-implant disease in patients undergoing supportive implant therapy. Diagn Microbiol Infect Dis 2017;88:47-52. https://doi.org/10.1016/j.diagmicrobio.2017.02.008
  41. Renvert S, Aghazadeh A, Hallstrom H, Persson GR. Factors related to peri-implantitis - a retrospective study. Clin Oral Implants Res 2014;25:522-9.

Cited by

  1. Xerostomia aggravates ligation‐induced peri‐implantitis: A preclinical in vivo study vol.32, pp.5, 2020, https://doi.org/10.1111/clr.13727