Morphology and severity of peri‐implantitis bone defects

Abstract

Background: Peri-implant defect morphology has shown to potentially impact upon the reconstructive outcomes for the management of peri-implantitis. Given the role that defect morphology plays upon the decision-making in the treatment of peri-implantitis, the present study aimed at assessing the morphology and severity of peri-implantitis bone defects and to insight on the patient-, implant-and site-related variables associated to these. Material and Methods:A cone-beam computed tomography study was carried out to classify peri-implantitis defects according to the type of defect, number of remaining bony walls and severity according to the extension of vertical bone loss.Three major defect categories were proposed: class I-infraosseous; class II-horizontal;class III-combined of class I and II. These were then subclassified into: (a) dehiscence; (b) 2/3-wall; and (c) circumferential-type defect. According to the severity the defects were further subclassified into: A: advanced; M: moderate; and S: slight. In addition, 20 site-, implant-, and patient-related variables were analyzed by generalized estimating equations (GEEs) of multilevel logistic regression models.Results: Based on an a priori power calculation, 332 implants were screened in 47 peri-implantitis patients. Of these, 158 peri-implantitis implants were eligible. The most prevalent defect morphology type was class Ib (55%) followed by class Ia (16.5%), and class IIIb (13.9%). On the contrary, the less frequent defect was class II (1.9%). The most frequent degree of severity was M (50.6%) with S (10.1%) being the least prevalent. Buccal bone loss was significantly greater compared to the other bony walls in class I and class III defects. Age was associated with the type of defect.Age and smoking habit were associated with the morphology of the defects, while smoking habit, type of prosthesis and distance to adjacent implant were associated with the severity of the defects (vertical bone loss).Conclusion: Peri-implantitis defects frequently course with an infraosseous component and often with buccal bone loss. Certain patient-, implant-, and site-specific variables are related with defect morphology and severity. However, morphological patterns for periimplantitis bone defects could not be proven (NCT NCT03777449).K E Y W O R D S alveolar bone, dental implants, diagnostic, implant stability, peri-implantitis, peri-implant mucositis

Association of prosthetic features and peri‐implantitis: A cross‐sectional study

“…The original concepts as outlined by previous authors hold true for implants. Monje et al () reported that 77.2% of the peri‐implantitis cases had inadequate access for cleansability. Serino and Ström () found that 74% of the implants had no access to proper plaque control and highlighted the role of prosthesis design.…”

Anti‐inflammatory and macrophage polarization effects of Cranberry Proanthocyanidins (PACs) for periodontal and peri‐implant disease therapy

“…[1][2][3] Comparably, peri-implantitis is a pathologic condition associated with biofilm formation and is characterized by "inflammation in the peri-implant mucosa and a progressive loss of supportive bone." [4][5][6][7][8] Strong evidence suggests that periodontitis is a risk factor for peri-implant disease. 5,9 Periodontitis and peri-implantitis have similar clinical and radiographic features but evident molecular and histopathological differences.…”

Histological characteristics of advanced peri-implantitis bone defects in humans

“…Peri-implantitis was defined as the combination of bleeding on gentle probing (BOP) with or without suppuration, probing depths (PD) ≥ 6 mm, and radiographic marginal bone loss (MBL) (i.e., interproximal bone levels ≥ 3 mm apical of the most coronal portion of the intraosseous part of the implant) [2]. All implant sites were associated with an advanced bone loss (> 6 mm/> 50% of the implant length) [14] and were clinically stable (i.e., no manually detected mobility) but were scheduled for explantation due to the advanced disease progression. The study protocol no.…”

“…Peri-implantitis lesions extend apical and are commonly associated with a circumferential pattern of bone loss [1,10]. Intraoperative clinical and radiographic assessments, however, do not fully represent the extension of peri-implantitis defects [11][12][13][14]. Moreover, the morphology of the remaining bone being exposed to masticatory forces has not been described so far.…”