Primordial and primary prevention of peri‐implant diseases: A systematic review and meta‐analysis

Abstract

Aim: This systematic review and meta-analysis aims to assess the efficacy of risk factor control to prevent the occurrence of peri-implant diseases (PIDs) in adult patients awaiting dental implant rehabilitation (primordial prevention) or in patients with dental implants surrounded by healthy peri-implant tissues (primary prevention). Materials and Methods:A literature search was performed without any time limit on different databases up to August 2022. Interventional and observational studies with at least 6 months of follow-up were considered. The occurrence of peri-implant mucositis and/or peri-implantitis was the primary outcome. Pooled data analyses were performed using random effect models according to the type of risk factor and outcome.Results: Overall, 48 studies were selected. None assessed the efficacy of primordial preventive interventions for PIDs. Indirect evidence on the primary prevention of PID indicated that diabetic patients with dental implants and good glycaemic control have a significantly lower risk of peri-implantitis (odds ratio [OR] = 0.16; 95% confidence interval [CI]: 0.03-0.96; I 2 : 0%), and lower marginal bone level (MBL) changes (OR = -0.36 mm; 95% CI: À0.65 to À0.07; I 2 : 95%) compared to diabetic patients with poor glycaemic control. Patients attending supportive periodontal/peri-implant care (SPC) regularly have a lower risk of overall PIDs (OR = 0.42; 95% CI: 0.24-0.75; I 2 : 57%) and peri-implantitis compared to irregular attendees. The risk of dental implant failure (OR = 3.76; 95% CI: 1.50-9.45; I 2 : 0%) appears to be greater under irregular or no SPC than regular SPC. Implants sites with augmented peri-implant keratinized mucosa (PIKM) show lower peri-implant inflammation (SMD = -1.18; 95% CI: À1.85 to À0.51; I 2 : 69%) and lower MBL changes (MD = -0.25; 95% CI: À0.45 to À0.05; I 2 : 62%) compared to dental implants with PIKM deficiency. Studies on smoking cessation and oral hygiene behaviors were inconclusive.Conclusions: Within the limitations of available evidence, the present findings indicate that in patients with diabetes, glycaemic control should be promoted to avoid peri-implantitis development. The primary prevention of peri-implantitis should involve regular SPC. PIKM augmentation procedures, where a PIKM deficiency exists,

Prevention and treatment of peri‐implant diseases—The EFP S3 level clinical practice guideline

“…For this guideline, a total of 13 SRs were conducted to support the guideline development process (Carra et al, 2023; Cosgarea et al, 2023; de Waal et al, 2023; Dommisch et al, 2023; Donos et al, 2023; Gennai et al, 2023; Karlsson et al, 2023; Liñares et al, 2023; Ramanauskaite et al, 2023; Stiesch et al, 2023; Teughels et al, 2023; Verket et al, 2023; Wilensky et al, 2023). The corresponding manuscripts are published within this special issue of the Journal of Clinical Periodontology .…”

“…Eleven observational studies including six case-control studies and five cohort studies (Carra et al, 2023).…”

“…Fourteen studies, 13 observational studies and 1 randomized clinical trial (RCT) (Carra et al, 2023).…”

“…(2) We suggest that, following surgical treatment of peri-implantitis, SPIC: Supporting literature (Carra et al, 2023;Stiesch et al, 2023) Quality of evidence Very low (indirect evidence for some components)…”

Six‐year extension results of a randomized trial comparing transcrestal and lateral sinus floor elevation at sites with 3–6 mm of residual bone

“…Differently, median mMBL and dMBL values observed in our lSFE group at 6 years are not consistent with the average 5‐year MBL value (0.72 mm) reported by Cannizzaro et al (2013) for implants placed concomitantly with lSFE. Also, differences in marginal bone loss as observed in our study between tSFE and lSFE groups could not be explained by differences in patient demographic characteristics (Table 1) or differences in patient/implant exposure to factors with a documented influence on peri‐implant MBL such as diabetes (Ayele et al, 2023; Lv et al, 2022), smoking status (Ayele et al, 2023; Uribarri et al, 2017), intensity/regularity of SPC (Atieh et al, 2021; Carra et al, 2023), and amount of supragingival plaque deposits (Mameno et al, 2020). It must be considered, however, that MBL assessments of the present study were based on nonstandardized radiographs, and the magnitude of marginal bone loss observed in the majority of the present tSFE and lSFE cases fell within the radiographic measurement error of 0.5 mm.…”