Treatment outcome in patients with peri-implantitis in a periodontal clinic: a retrospective study.

BACKGROUND: The number of placed implants has grown during the past decade, and the prevalence of peri-implantitis has increased. The purpose of the present study is to investigate the treatment outcome of peri-implantitis and to identify factors influencing the treatment success rate. METHODS: The study was conducted as a retrospective longitudinal study on a referral population. The material included 382 implants with peri-implantitis in 150 patients. Peri-implantitis was defined as presence of pocket depths ≥5 mm, bleeding at probing and/or suppuration, and the presence of implant radiographic bone loss ≥3 mm or bone loss comprising at least three threads of the implant. Variance analyses, χ(2) analyses, and logistic regression analysis were used for data analyses. RESULTS: The mean age of the participants at baseline was found to be 64 years (range: 22 to 87 years). The mean ± SD follow-up time was 26 ± 20 months, and the mean time between implant installation and baseline was 6.4 years (range: 1 to 20 years). Periodontal flap surgery with osteoplasty was the most common type of therapy (47%), and regenerative surgery procedures with bone substitute materials were chosen in 20% of the cases. The mean success rate at patient level was 69%. The results of the logistic regression analyses showed that the success rate was significantly lower for individuals with the diagnosis of severe periodontitis, severe marginal bone loss around the implants, poor oral hygiene, and low compliance. CONCLUSION: The effectiveness of the peri-implantitis therapy was impaired by severe periodontitis, severe marginal bone loss around the implants, poor oral hygiene, and low compliance.

Clinical follow-up of unilateral, fixed dental prosthesis on maxillary implants.

AIMS/BACKGROUND: The aims of the present study were to evaluate (1) the success rate of unilateral maxillary fixed dental prosthesis (FDPs) on implants in patients at a periodontal clinic referred for periodontal treatment, (2) the prevalence of varying mechanical and biological complications and (3) effects of potential risk factors on the success rate. MATERIAL AND METHODS: Fifty consecutive patients were invited to participate in a follow-up. The patients had received FDPs on implants between November 2000 and December 2003 after treatment to achieve optimal peridontal health, and the FDPs had been in function for at least 3 years. A questionnaire was sent to the patients before the follow-up examination. Forty-six patients with 116 implants were examined. The follow-up comprised clinical and radiographic examinations and evaluations of treatment outcome. RESULTS: Before implant treatment, 13% of the teeth were extracted; of these, 80% were extracted due to periodontal disease. No implants had been lost before implant loading. One implant in one patient fractured after 3 years of functional loading and three implants in another patient after 6.5 years. The most frequent mechanical complications were veneer fractures and loose bridge screws. Patients with peri-implant mucositis had significantly more bleeding on probing around teeth and implants. Patients with peri-implantitis at the follow-up had more deep periodontal pockets around their remaining teeth compared with individuals without peri-implantitis, but these differences were not significant. Smokers had significantly fewer teeth, more periodontal pockets ≥ 4mm and a tendency towards greater marginal bone loss at the follow-up, compared with non-smokers. CONCLUSION: In the short term, overloading and bruxism seem more hazardous for implant treatment, compared with a history of periodontitis.

Relationship between compliance and periodontal treatment outcome in smokers.

BACKGROUND: Smoking is an established risk factor of periodontal disease and smokers are regarded as patients with a high risk of periodontitis recurrence during the maintenance phase. Lack of compliance and smoking constitute significant factors for the risk of further periodontitis progression. The purpose of the present study was to investigate the relationship between periodontal status and the tendency to interrupt periodontal treatment and determine if this relationship differs significantly between smokers and non-smokers. METHODS: The investigation was conducted as a retrospective study on a sample of 325 patients referred for treatment. The patients had been offered full periodontal treatment and a full-mouth oral radiographic examination. In order to investigate any correlations between periodontal status and smoking or interrupted periodontal treatments, stepwise multiple regression analyses were adopted. RESULTS: The mean age of the sample was 49.7 years (range 25 to 83) and a majority were females (57%). The relative frequency of smoking was 52%. The relative frequency of interruption of periodontal treatment was 26% for non-smokers and 31% for smokers. Smokers who interrupted periodontal treatment after the reevaluation were found to have significantly deeper periodontal probing depths at the reevaluation compared to those who did not interrupt the treatment irrespective of smoking habits (P<0.001). CONCLUSIONS: The results of the study demonstrate that the non-complying individuals had the highest risk of recurrent periodontitis even if they had completed the treatment plan. An important task in the future will be to find ways to reduce the frequency of non-compliance and thus improve the prognosis.