Peri-implantitis Update: Risk Indicators, Diagnosis, and Treatment

Abstract

Despite the success rates of dental implants, peri-implantitis presents as the most common complication in implant dentistry. This review discusses various factors associated with peri-implantitis and various available treatments, highlighting their advantages and disadvantages. Relevant articles on peri-implantitis published in English were reviewed from August 2010 to April 2020 in MEDLINE/PubMed, Scopus, and ScienceDirect. The identified risk indicators of peri-implant diseases are plaque, smoking, history of periodontitis, surface roughness, residual cement, emergence angle >30 degrees, radiation therapy, keratinized tissue width, and function time of the implant, sex, and diabetes. Peri-implantitis treatments can be divided into nonsurgical (mechanical, antiseptic, and antibiotics), surface decontamination (chemical and laser), and surgical (air powder abrasive, resective, and regenerative). However, mechanical debridement alone may fail to eliminate the causative bacteria, and this treatment should be combined with other treatments (antiseptics and surgical treatment). Surface decontamination using chemical agents may be used as an adjuvant treatment; however, the definitive clinical benefit is yet not proven. Laser treatment may result in a short-term decrease in periodontal pocket depth, while air powder abrasive is effective in cleaning a previously contaminated implant surface. Surgical elimination of a pocket, bone recontouring and plaque control are also effective for treating peri-implantitis. The current evidence indicates that regenerative approaches to treat peri-implant defects are unpredictable.

A Seven-year Follow-up Study of Patient Satisfaction with Three-implant-retained Mandibular Overdentures

“…In this 7-year follow-up study, the basic scores for the mandibular overdentures retained with clip-bar attachment in comparison to conventional complete dentures are consistent with those obtained in other investigations using the same questionnaires and scale setup [12].…”

The Crucial Role of Plaque Control in Peri-Implant Mucositis Initiation as Opposed to the Role of Systemic Health Condition: A Cross-Sectional Study

“…Most, if not all, studies agree on the fact that systemic diseases, especially diabetes mellitus and dental plaque, are causative and risk factors for the development of peri-implant diseases. 11 , 27 …”

“…That being said, it does not underestimate the danger of serious deterioration and eventual loss of the implant and the surrounding bone due to true peri-implantitis, despite the advancement in implantology mentioned above, all these fearsome scenarios start with a reversible disease, namely the peri-implant mucositis, 11 that develops mainly due to lack of proper plaque control in addition to other systemic risk factors; mostly diabetes mellitus and behavioral risk factors such as smoking. 12 , 13 …”

The Effect of Recombinant Human Bone Morphogenetic Protein-7 on the Osteoblast-like Cells Cultured on Implant

“…The materials used are bone grafts, with or without membranes, or membrane alone. Biologic agents, such as growth factors or bone morphogenetic proteins (BMP), can be considered [3].…”

“…Researches have been conducted for over the years finding the treatment procedures for the regeneration of a lost or injured part so that form and function of lost structures can be regained. This regenerative field holds the promise of engineering damaged tissues with the help of various growth factors, including bone morphogenetic proteins (BMPs), by stimulating the body's own repair mechanisms [3]. BMPs are a group of signaling molecules that belong to the transforming growth factor-β superfamily of proteins.…”