Prevention and management of peri‐implant mucositis and peri‐implantitis: A systematic review of outcome measures used in clinical studies in the last 10 years

Abstract

Objectives To evaluate outcome measures, methods of assessment, and analysis in clinical studies on the prevention and management of peri‐implant mucositis and peri‐implantitis. Methods Systematic electronic searches (CENTRAL/MEDLINE/SCOPUS) up to April 2021 were conducted to identify longitudinal clinical studies with ≥10 patients on either the prevention or management of peri‐implant diseases. Outcome measures of this analysis were the choice of outcome measures, methods of assessment, and analytical methods. Risk of bias was evaluated according to study design. Data were extracted into evidence tables and outcomes were analysed in a descriptive manner. Results The analysis of the 159 selected studies revealed that probing pocket depth (PPD) and bleeding/suppuration on probing (BOP) were reported in 89% and 87% of all studies, respectively. Additional outcome measures included plaque scores (reported in 64% of studies), radiographic outcomes (49%), soft tissue dimensions (34%), and composite outcomes (26%). Adverse events (8%) and patient‐reported outcomes (6%) were only rarely mentioned. A primary outcome measure was clearly defined only in 36% of studies. Data on PPD, radiographic outcomes, and soft tissue dimensions were primarily reported as mean values and rarely as frequency distributions. For radiographic outcomes and soft tissue dimensions, it was frequently unclear how clustered data were handled. Conclusions PPD and BOP were routinely reported in studies on the prevention and management of peri‐implant mucositis and peri‐implantitis, while composite outcomes, adverse events, and patient‐reported outcomes were only infrequently described.

Resolution of peri‐implant mucositis at tissue‐ and bone‐level implants: A 6‐month prospective controlled clinical trial

“…In the majority of trials on the treatment of PM the primary outcome was based on PD reduction (Derks et al, 2022), while in the present study the BOP was set as primary outcome. In agreement to a previous report by Renvert et al (2018), the PD changes cannot be considered as primary diagnostic parameter for PM, because the probing depth at implant sites depends on the height of the soft tissues at implant location (i.e., mucosal tunnel).…”

“…In the majority of trials on the treatment of PM the primary outcome was based on PD reduction (Derks et al, 2022), while in 43.9 ± 7.4 21.9 ± 2.9 22.5 ± 3.9 21. TA B L E 3 FMPS and FMBS at baseline and after 1-, 3-, and 6-month follow-ups.…”

Early marginal bone loss around dental implants to define success in implant dentistry: A retrospective study

“…10 It is even more interesting that to define the onset and pattern of progression of peri-implantitis in their population, the assessment was solely based on radiographic and not clinical signs of progressive MBL. 11 In this same sense, it is important to note that, although some studies associate clinical parameters to the severity of peri-implant diseases, 34 the meta-analytic evaluation of more than 4000 patients treated with more than 9500 implants of different brands and treatment protocols found no correlation between mean probing depth and mean bleeding on probing with mean MBL, which was also irrespective of follow-up. 3 Based on the definition of peri-implantitis at 0.5 mm of radiographical bone loss, used by Derks and colleagues in 2016, in the analyzed Swedish population, with a really good dental and implantology tradition, and a very good public health system, a 45% of patients and 24.9% of implants would have peri-implantitis; almost half the population in their random sample would show peri-implantitis and one in four implants.…”

“…It is even more interesting that to define the onset and pattern of progression of peri‐implantitis in their population, the assessment was solely based on radiographic and not clinical signs of progressive MBL 11 . In this same sense, it is important to note that, although some studies associate clinical parameters to the severity of peri‐implant diseases, 34 the meta‐analytic evaluation of more than 4000 patients treated with more than 9500 implants of different brands and treatment protocols found no correlation between mean probing depth and mean bleeding on probing with mean MBL, which was also irrespective of follow‐up 3 …”

Use of the Probiotic Bifidobacterium animalis subsp. lactis HN019 in Oral Diseases

“…Currently, the use of dental implants in oral rehabilitation is increasing in popularity, because of their ability to address aesthetic and functional needs and due to their durability and high success rates [ 85 ]. However, there are frequent complications with dental implants, such as peri-implant mucositis and peri-implantitis [ 86 , 87 ]. Healthy peri-implant mucosa is composed of keratinized epithelium and its basal lamina faces the surface of the dental implant or abutment [ 86 , 88 ].…”