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.

1 Follower
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background Bacteria are major contributors to the rising number of dental implant failures. Inflammation secondary to bacterial colonization and bacterial biofilm is a major etiological factor associated with early and late implant failure (peri-implantitis). Even though there is a strong association between bacteria and bacterial biofilm and failure of dental implants, their effect on the surface of implants is yet not clear.PurposeTo develop and establish an in vitro testing methodology to investigate the effect of early planktonic bacterial colonization on the surface of dental implants for a period of 60 days.Materials and Methods Commercial dental implants were immersed in bacterial (Streptococcus mutans in brain-heart infusion broth) and control (broth only) media. Immersion testing was performed for a period of 60 days. During testing, optical density and pH of immersion media were monitored. The implant surface was surveyed with different microscopy techniques post-immersion. Metal ion release in solution was detected with an electrochemical impedance spectroscopy sensor platform called metal ion electrochemical biosensor (MIEB).ResultsBacteria grew in the implant-containing medium and provided a sustained acidic environment. Implants immersed in bacterial culture displayed various corrosion features, including surface discoloration, deformation of rough and smooth interfaces, pitting attack, and severe surface rusting. The surface features were confirmed by microscopic techniques, and metal particle generation was detected by the MIEB.Conclusion Implant surface oxidation occurred in bacteria-containing medium even at early stages of immersion (2 days). The incremental corrosion resulted in dissolution of metal ions and debris into the testing solution. Dissolution of metal ions and particles in the oral environment can trigger or contribute to the development of peri-implantitis at later stages.
    Clinical Implant Dentistry and Related Research 02/2015; DOI:10.1111/cid.12285 · 2.80 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: The aim of this systematic review was to evaluate the long-term outcomes of patients with periodontitis submitted to periodontal therapy/maintenance and implant placement. Material and Methods: Studies reporting clinical and/or long-term implant outcomes from partially edentulous patients with periodontitis who were treated and followed periodontal maintenance for at least 5 years were considered eligible for the review. Screening of the articles, data extraction and quality assessment were conducted independently and in duplicate. Results: Search of MEDLINE, EMBASE and CENTRAL databases resulted in 959 papers, and of them 931 were excluded after title/abstract assessment. The full texts of 28 potentially eligible publications were screened, but only 10 studies met inclusion criteria. Most of the included studies (77.8%) presented a medium/high methodological quality. The results demonstrated that patients with a diagnosis of periodontitis had satisfactory implants outcomes. Implant survival was high (92.1%) within studies reporting a 10 years of follow up. Parameters related to pocket depth (PD), clinical attachment level (CAL) and bone loss (BL) around teeth increased the occurrence of peri-implantitis and implant loss. Non-attendance to periodontal maintenance and smoking habits were also associated with decreased implant outcomes. Conclusions: This systematic review confirmed that implant therapy can be successfully used in patients with diagnosis of periodontitis who underwent proper therapy and regular periodontal maintenance. Residual pockets, non-attendance to periodontal maintenance program and smoking were considered to be negative factors for the long-term implant outcomes.
    Journal of Periodontology 10/2014; 86(2):1-22. DOI:10.1902/jop.2014.140390 · 2.57 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Peri-implant disease represents a collective term to describe inflammatory reactions in the tissues surrounding an implant. Results from clinical and experimental studies revealed that the tissue response to plaque formation at teeth and dental implants is similar. However, while peri-implantitis and periodontitis have many clinical features in common, structural differences in supporting tissues between implants and teeth may influence host response to infection. Here a SEM evaluation was reported to evaluate quality of bacteria and the pertinent literature discussed. Ten implants had to be removed for progressive marginal bone loss during follow-up period. The implants surface was examined under a Scanning Electron Microscopy (SEM LEO, Cambridge, England) with tilt angles ranging from 10 to 45 degrees. SEM evaluations were performed by three independent observers who expressed an estimate of bacterial amount of three different areas: supra-crestal, sub-crestal and screw threads. Plaque formation and gingival inflammation were observed into the junctional epithelium-to-implant contacts, with also active or previous bone resorption. In peri-implantitis the implant surface facilities the adherence of the biofilm bacteria and complicates its elimination. Most of chemical and mechanical devices are not able to completely remove bacteria from implant surface especially if they are enclosed in calcified areas. Bacteria determine an inflammatory process which determines bone resorption around fixtures and thus implant mobility occurs. Identification of bacteria types is of paramount importance in order to perform specific therapy to eliminate peri-implant colonies.
    European Journal of Inflammation 04/2012; 10(1 (s2)):7-12. · 0.99 Impact Factor

Full-text (2 Sources)

Available from
Sep 5, 2014