Severity and pattern of peri-implantitis-associated bone loss.

• Objective: The purpose of the present study was to describe the severity and pattern of peri-implantitis-associated bone loss. Material and Methods: Intra-oral radiographs from 182 subjects were analysed. Bone-level measurements were performed in 419 implants with a history of bone loss. All radiographs obtained in the interval from the 1-year follow-up to the end-point examination (5–23 years) were analysed. The amount of bone loss that occurred from 1 year after prosthesis insertion was assessed and the pattern of bone loss was evaluated. Results: The average bone loss after the first year of function was 1.68 mm and 32% of the implants demonstrated bone loss geqslant R: gt-or-equal, slanted2 mm. The multilevel model revealed that the bone loss showed a non-linear pattern and that the rate of bone loss increased over time. The model also revealed that the pattern of peri-implantitis associated bone loss was similar within the same subject. Conclusion: It is suggested that peri-implantitis-associated bone loss varies between subjects and is, in most cases, characterized by a non-linear progression, with the rate of loss increasing over time. One of the main goals in implant therapy is to preserve tissue integration and thereby maintain bone support. Marginal bone loss is thus considered a critical outcome variable in the evaluation of implant therapy. It has been suggested that data on bone loss during the first year of function should be distinguished from that occurring during the subsequent period of service. According to the suggested success criteria for implants (Albrektsson et al. 1986, Albrektsson & Zarb 1993), marginal bone loss should not exceed 1.5 mm during the first year in function and should be <0.2 mm/year thereafter. A modification to these criteria that indicated a maximum bone loss of 2 mm between prosthesis installation and 5 years of follow-up was presented in a consensus report from the European Workshop on Periodontology in 1999 (Wennström & Palmer 1999). Whether certain amounts of bone loss around implants should be acceptable or not requires an understanding of the mechanisms involved in the process of bone resorption. Although the question on the aetiology of marginal bone loss around implants still has to be completely unravelled, previous studies have demonstrated the association between progressive bone loss during function and clinical signs of inflammation in peri-implant tissues (Roos-Jansåker et al. 2006, Fransson et al. 2008). We have previously reported on the prevalence and extent of peri-implantitis-associated bone loss (Fransson et al. 2005, 2009). From the analysis of radiographs obtained from 662 subjects treated with implant-supported prosthesis, it was documented that 184 (27.8%) of the subjects had geqslant R: gt-or-equal, slanted1 implant with peri-implantitis-associated bone loss (Fransson et al. 2005, 2008). Within this group of subjects, about 40% of the implants were affected (Fransson et al. 2009). Using this subject sample, the purpose of the present study was to describe the severity and pattern of peri-implantitis-associated bone loss.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Odontologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Dentistry (hsv//eng)

Keyword

Alveolar Bone Loss

etiology

pathology

radiography

Chi-Square Distribution

Dental Implants

adverse effects

Disease Progression

Follow-Up Studies

Humans

Models

Statistical

Multilevel Analysis

methods

Periodontitis

etiology

radiography

Time Factors

Publication and Content Type

ref (subject category)

art (subject category)