Impact of design elements of the implant supracrestal complex (ISC) on the risk of peri‐implant mucositis and peri‐implantitis: A critical review

Abstract

Objective The aim of this review was to investigate the evidence correlating the emergence profile (EP) and emergence angle (EA), peri‐implant tissue height, implant neck design, abutment and/or prosthesis material, retention and connection types with risk of peri‐implant mucositis and peri‐implantitis. Methods Seven focus questions were identified, and seven electronic search queries were conducted in PubMed. Human studies reporting on bleeding on probing, probing depth or case definitions of peri‐implant mucositis and peri‐implantitis were included. Results Emerging evidence with bone‐level implants suggests a link between EA combined with convex EP and peri‐implantitis. Depth of the peri‐implant sulcus of ≥3 mm is shown to be reducing the effectiveness of treatment of established peri‐implant mucositis. Modification of the prosthesis contour is shown to be an effective supplement of the anti‐infective treatment of peri‐implant mucositis. Limited evidence points to no difference with regard to the risk for peri‐implant mucositis between tissue‐ and bone‐level implants, as well as the material of the abutment or the prosthesis. Limited evidence suggests the use or not of prosthetic abutments in external connections and does not change the risk for peri‐implantitis. Literature with regard to prosthesis retention type and risk for peri‐implantitis is inconclusive. Conclusions Limited evidence indicates the involvement of EA, EP, sulcus depth and restricted accessibility to oral hygiene in the manifestation and/or management of peri‐implant mucositis/peri‐implantitis. Conclusions are limited by the lack of consensus definitions and validated outcomes measures, as well as diverse methodological approaches. Purpose‐designed studies are required to clarify current observations.

Implant‐abutment emergence angle and profile in relation to peri‐implantitis: A systematic review

“…To further clarify this relationship, more high-quality evidence research is needed. A report (Schwarz et al, 2021) and review article (Mattheos et al, 2021) also discuss the relation between EA and EP in relation to peri-implantitis. Both papers carefully suggest the possibility of a higher peri-implantitis prevalence due to a larger EA in combination with a convex EP, also based on the papers of Katafuchi et al (2018) and Yi et al (2020).…”

Can computer‐assisted implant surgery improve clinical outcomes and reduce the frequency and intensity of complications in implant dentistry? A critical review

“…Some have suggested CAIS could reduce the invasiveness, complexity, and duration of surgical interventions, while others have reported increasing patients’ satisfaction and acceptance 5 . Finally, as this technology aims to empower the proper prosthetic‐driven implant placement, it could potentially impact the long‐term outcomes of implant therapy by allowing implant placement in the optimal position and angulation for prosthetic designs that could promote sustainable esthetic outcomes and health of the peri‐implant tissue 6,7 . Optimal positioning of the implants may also reduce the cost of reconstruction, by allowing the use of stock abutments and minimizing the need for expensive customized solutions.…”

The Effect of Microcosm Biofilm Decontamination on Surface Topography, Chemistry, and Biocompatibility Dynamics of Implant Titanium Surfaces

“…Different non-surgical and surgical solutions have been advocated for the treatment of peri-implantitis [ 7 , 8 , 9 , 10 , 11 ]. The successful clinical management of peri-implantitis is based on the evaluation of composite therapeutic end-points, that correspond to disease resolution.…”