Outcome of implant therapy in patients with previous tooth loss due to periodontitis

Department of Oral and Maxillofacial Surgery, Aalborg Hospital, Aarhus University, Aalborg, Denmark.
Clinical Oral Implants Research (Impact Factor: 3.12). 11/2006; 17 Suppl 2(S2):104-23. DOI: 10.1111/j.1600-0501.2006.01347.x
Source: PubMed

ABSTRACT It is frequently debated whether implant treatment in individuals with previous tooth loss due to periodontitis is characterized by an increased incidence of implant loss and peri-implantitis.
The objective of the present systematic review was to assess whether individuals with previous tooth loss due to periodontitis have an increased risk of loss of suprastructures, loss of implants, peri-implantitis, and peri-implant marginal bone loss as compared with individuals with previous tooth loss due to reasons other than periodontitis.
Studies considered for inclusion were searched in MEDLINE (PubMed) and relevant journals were hand searched. Moreover, reference lists of articles selected for full-text screening as well as previously published reviews relevant for the present systematic review were searched. The search was performed by one reviewer and was restricted to human studies published from January 1, 1980 to January 1, 2006. No language restrictions were applied.
Prospective and retrospective cohort studies with at least a 5-year follow-up comparing the outcome of implant treatment in individuals with periodontitis-associated and non-periodontitis-associated tooth loss, respectively, were included. The outcome measures were survival of suprastructures, survival of implants, occurrence of peri-implantitis, and peri-implant marginal bone loss. The 5- and 10-year time points were evaluated.
Screening of eligible studies, methodological quality assessment, and data extraction were conducted in duplicate and independently by two of the authors. The authors were contacted for missing information. Results were expressed as random effect models using weighted mean differences for continuous outcomes and relative risk for dichotomous outcomes with 95% confidence intervals (CIs).
Two studies with a 5- and 10-year follow-up, respectively, were identified including a total of 33 patients with tooth loss due to periodontitis and 70 patients with non-periodontitis-associated tooth loss. There was no significant difference in the survival of the suprastructures after 5 years. Furthermore, there were no significant differences in the survival of the implants after 5 and 10 years. However, there were significantly more patients affected by peri-implantitis in the group with periodontitis-associated tooth loss during the 10-year follow-up period, risk ratio (RR) 9 (95% CI 3.94-20.57). Moreover, significantly increased peri-implant marginal bone loss was observed in patients with periodontitis-associated tooth loss after 5 years, mean difference 0.5 mm (95% CI 0.06-0.94).
The survival of the suprastructures and the implants was not significantly different in individuals with periodontitis-associated and non-periodontitis-associated tooth loss. However, significantly increased incidence of peri-implantitis and significantly increased peri-implant marginal bone loss were revealed in individuals with periodontitis-associated tooth loss. The small sample size and the methodological quality assessment of the two studies suggest that the results should be interpreted with caution. Consequently, further long-term studies focusing particularly on the outcome of implant treatment in young adults with aggressive periodontitis are needed before final conclusions can be drawn about the outcome of implant treatment in patients with a history of periodontitis.

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Available from: Palle Holmstrup, Sep 05, 2014
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    • "may affect peri-implant resorption (Schou et al. 2006), because the bacterial contamination of the implant–abutment junction from the oral cavity was shown to trigger hard tissue response (Cochran et al. 1997). Many strategies have been advocated to clinically minimize the effect of this contamination: mechanical improvement of the implant/abutment connection stability (Van Assche et al. 2011), implant/abutment microgap shifting from the vital bone (Degidi et al. 2008; Vigolo & Givani 2009; Canullo et al. 2010a), diminishing times of the abutment dis/reconnection (Canullo et al. 2010b); nevertheless, a minimal bone resorption (0.5 mm) has been observed in longitudinal analysis (Annibali et al. 2012). "
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    Clinical Oral Implants Research 11/2013; 00. DOI:10.1111/clr.12290 · 3.12 Impact Factor
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    • "Ito et al. (2011) reported that most of the patients who requested dental implant treatment had been suffering from periodontal disease. It has been reported that patients with periodontal disease are more susceptible to peri-implantitis (Hardt et al. 2002; Schou et al. 2006). Moreover, microbiological studies documented a correlation between failed implant therapy and periodontal pathogens (Mombelli & Lang 1998; Quirynen et al. 2002, 2006; Shibli et al. 2008). "
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    • "Missing teeth can be replaced successfully with reconstructions anchored on osseointegrated implants. Several narrative and systematic reviews are available reporting the survival of implants in relation to subjectspecific factors such as tobacco smoking, systemic diseases, or periodontitis (Mombelli & Cionca 2006; Schou et al. 2006; Karoussis et al. 2007; Klokkevold & Han 2007; Quirynen et al. 2007; Ong et al. 2008; Bornstein et al. 2009; Heitz-Mayfield & Huynh-Ba 2009; Safii et al. 2010). The total literature available today suggests that over a period of 10 years roughly 1 of 20 implants is lost. "
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