Retrospective Evaluation Prevalence of Peri-implantitis in the Turkish Population for 3 Years

Abstract

Aim: This study aims to evaluate the prevalence of peri-implantitis in the Turkish population, to examine the effects of systemic diseases, smoking, and drug use on peri-implantitis, and to investigate other factors that may cause marginal bone loss. Material and Method: The study was conducted with 205 patients who received implants and 694 implants. The files of the patients who came for regular follow-up were examined, bone loss was calculated based on panoramic x-rays, implants with 2 mm or more bone loss and purulent discharge and bleeding on probing were detected with peri-implantitis, those with at least one implant with peri-implantitis or implants with bone loss. Patients with failed implants were considered to have peri-implantitis. In the measurements, the X-rays taken before the start of prosthetic treatment were considered the first, and the X-rays taken in the third year following the prosthetic treatment were considered the last X-ray. While evaluating the findings obtained in the study, the IBM SPSS Statistics 22 program was used for statistical analysis. While evaluating the study data, in addition to descriptive statistical methods (frequency), Chi-Square test and Continuity (Yates) Correction were used to compare quantitative and qualitative data. Univariate and multivariate logistic regression analysis was applied to evaluate the effects on bone loss and peri-implantitis. Significance was evaluated at p<0,05 level. Results: The incidence of peri-implantitis was significantly higher in patients with systemic diseases and those receiving or not receiving treatment for them and with the number of implants in the mouth between 9-12 (p<0,05). Again, the rate of bone loss of 2 mm or more is significantly higher in implants applied to patients who have systemic diseases and are treated or not treated for them (p<0,05), who smoke (p<0,05), and who have a history of periodontitis (p<0,05). Bone loss was found to be significantly higher in implants applied to the posterior maxilla (p<0,05), narrow-diameter implants (p<0,05), and implants supporting removable prosthesis (p<0,05). Conclusion: Within the limits of this study, systemic disease, smoking, the patient’s history of periodontitis, and the increase in the number of implants applied should be considered as risk factors, and it seems that the area where the implant is applied and the implant diameter affect bone loss.

Keywords

• Alveolar bone loss
• dental implant
• peri-implantitis
• smoking
• systemic disease

Peri-implantitis Prevalansında Türk Popülasyonundaki 3 Yıllık Takibinin Retrospektif Olarak Değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, peri-implantitisin Türk popülasyonundaki prevalansını değerlendirmek, sistemik hastalıkların, sigara ve ilaç kullanımının peri-implantitis üzerindeki etkisini incelemek ve marjinal kemik kaybına neden olabilecek diğer faktörleri araştırmaktır. Gereç ve Yöntem: Çalışma implant uygulanmış 205 hasta ve uygulanan 694 implant ile yapılmıştır. Düzenli takiplerine gelen hastaların dosyaları incelenmiş, panoramik röntgenler üzerinden kemik kayıpları hesaplamış, 2 mm ve üzeri kemik kaybı olan ve muayenesi sırasında pürülan akıntı ve/veya sondalamada kanama bulunan implantlar peri-implantitisli, en az bir peri-implantitisli implantı bulunan veya kemik kaybına bağlı uygulaması başarısız olan implanta sahip hastalar peri-implantitise sahip hasta olarak kabul edilmiştir. Ölçümlerde protetik tedavi başlangıcı öncesi alınan röntgenler ilk, protetik tedaviyi takiben üçüncü yılda alınan röntgen son röntgen kabul edilmiştir. Çalışmada elde edilen bulgular değerlendirilirken, istatistiksel analizler için IBM SPSS Statistics 22 programı kullanılmıştır. Çalışma verileri değerlendirilirken tanımlayıcı istatistiksel metodların (frekans) yanısıra niceliksel niteliksel verilerin karşılaştırılmasında Ki-Kare testi ve Continuity (Yates) Düzeltmesi kullanılmıştır. Kemik kaybı ve periimplantitis üzerine etkileri değerlendirmek için tek değişkenli ve çok değişkenli lojistik regresyon analizi uygulanmıştır. Anlamlılık p<0,05 düzeyinde değerlendirilmiştir. Bulgular: Sistemik hastalığı bulunan ve bunlarla ilgili tedavi gören/görmeyen ve ağızda implant sayısı 9-12 arası olan hastalarda peri-implantitis görülme sıklığı anlamlı derecede fazla bulunmuştur (p<0,05). Yine sistemik hastalığı bulunan ve bunlarla ilgili tedavi gören/görmeyen (p<0,05), sigara kullanan (p<0,05), periodontitis geçmişi bulunan (p<0,05) hastalara uygulanan implantlarda 2 mm ve üzeri kemik kaybı görülme oranı anlamlı olarak daha yüksektir. Maksilla posteriora uygulanan implantlarda (p<0,05), dar çaplı implantlarda (p<0,05) ve hareketli proteze destek olan implantlarda (p<0,05) kemik kaybı anlamlı derecede yüksek bulunmuştur. Sonuç: Bu çalışmanın sınırları dahilinde sistemik hastalığın, sigara kullanımının, hastanın periodontitis geçmişinin ve uygulanan implant sayısındaki artışının bir risk faktörü olarak kabul edilmesi gerekmektedir ve implantın uygulandığı bölgenin ve implant çapının kemik kaybı üzerine etkisi olduğu görülmektedir.

Keywords

• Alveoler kemik kaybı
• dental implant
• peri-implantitis
• sigara
• sistemik hastalık

References

1. Kullar AS, Miller CS. Are There Contraindications for Placing Dental Implants?. Dent Clin North Am. 2019;63(3):345-362. doi:10.1016/j.cden.2019.02.004
2. Andersson L, Kahnberg KE, Ma P. Oral and maxillofacial surgery, in oral and maxillofacial surgery. 2010, Wiley-Blackwell. : 359.
3. Tonetti MS, Gerber L, Lang NP. Vascular adhesion molecules and initial development of inflammation in clinically healthy human keratinized mucosa around teeth and osseointegrated implants. J Periodontal Res. 1994;29(6):386-392. doi:10.1111/j.1600-0765.1994.tb01239.x
4. Heitz-Mayfield LJA, Salvi GE. Peri-implant mucositis. J Periodontol. 2018;89 Suppl 1:S257-S266. doi:10.1002/JPER.16-0488
5. Liaw K, Delfini RH, Abrahams JJ. Dental Implant Complications. Semin Ultrasound CT MR. 2015;36(5):427-433. doi:10.1053/j.sult.2015.09.007
6. Wilson V. An insight into peri-implantitis: a systematic literature review. Prim Dent J. 2013;2(2):69-73. doi:10.1308/205016813806144209
7. Hämmerle CH, Brägger U, Bürgin W, Lang NP. The effect of subcrestal placement of the polished surface of ITI implants on marginal soft and hard tissues. Clin Oral Implants Res. 1996;7(2):111-119. doi:10.1034/j.1600-0501.1996.070204.x
8. Smeets R, Henningsen A, Jung O, Heiland M, Hammächer C, Stein JM. Definition, etiology, prevention and treatment of peri-implantitis--a review. Head Face Med. 2014;10:34. Published 2014 Sep 3. doi:10.1186/1746-160X-10-34

9. Atieh MA, Alsabeeha NH, Faggion CM Jr, Duncan WJ. The frequency of peri-implant diseases: a systematic review and meta-analysis. J Periodontol. 2013;84(11):1586-1598. doi:10.1902/jop.2012.120592
10. Haas R, Mensdorff-Pouilly N, Mailath G, Watzek G. Survival of 1,920 IMZ implants followed for up to 100 months. Int J Oral Maxillofac Implants. 1996;11(5):581-588.
11. Haas R, Mensdorff-Pouilly N, Mailath G, Watzek G. Survival of 1,920 IMZ implants followed for up to 100 months. Int J Oral Maxillofac Implants. 1996;11(5):581-588.
12. Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975;25(4):229-235.
13. Machin, D. Campbell, M. Fayers, P. and Pinol, A. 1997. Sample Size Tables for Clinical Studies, 2nd Edition. Blackwell Science. Malden, MA.
14. Dreyer H, Grischke J, Tiede C, et al. Epidemiology and risk factors of peri-implantitis: A systematic review. J Periodontal Res. 2018;53(5):657-681. doi:10.1111/jre.12562
15. Derks J, Schaller D, Håkansson J, Wennström JL, Tomasi C, Berglundh T. Peri-implantitis - onset and pattern of progression. J Clin Periodontol. 2016;43(4):383-388. doi:10.1111/jcpe.12535
16. Renvert S, Aghazadeh A, Hallström H, Persson GR. Factors related to peri-implantitis - a retrospective study. Clin Oral Implants Res. 2014;25(4):522-529. doi:10.1111/clr.12208
17. Marrone A, Lasserre J, Bercy P, Brecx MC. Prevalence and risk factors for peri-implant disease in Belgian adults. Clin Oral Implants Res. 2013;24(8):934-940. doi:10.1111/j.1600-0501.2012.02476.x
18. Capparè P, Tetè G, D’Orto B, Nagni M, Gherlone EF. Immediate Loaded Full-Arch Mandibular Rehabilitations in Younger vs. Elderly Patients: A Comparative Retrospective Study with 7-Year Follow-Up. J Clin Med. 2023;12(13):4524. Published 2023 Jul 6. doi:10.3390/jcm12134524
19. Passoni BB, Dalago HR, Schuldt Filho G, et al. Does the number of implants have any relation with peri-implant disease?. J Appl Oral Sci. 2014;22(5):403-408. doi:10.1590/1678-775720140055
20. Ohnishi Y, Fujii T, Ishikawa J, Ishibashi M, Higashiyama M, Hiraoka SI. Effects of Prophylaxis with Oral Supportive Care for Peri-implantitis in Patients Undergoing Malignancy Chemotherapy. Oral Health Prev Dent. 2021;19(1):547-554. doi:10.3290/j.ohpd.b2183011
21. Reis INRD, do Amaral GCLS, Hassan MA, et al. The influence of smoking on the incidence of peri-implantitis: A systematic review and meta-analysis. Clin Oral Implants Res. 2023;34(6):543-554. doi:10.1111/clr.14066
22. Alqahtani M. Influence of Moderate Cigarette Smoking on the Peri-Implant Clinicoradiographic Inflammatory Parameters Around Cement- and Screw-Retained Dental Implants. J Oral Implantol. 2021;47(6):473-477. doi:10.1563/aaid-joi-D-19-00352
23. Hu Y, Zhou W, Zhu C, et al. The Synergistic Effect of Nicotine and Staphylococcus aureus on Peri-Implant Infections. Front Bioeng Biotechnol. 2021;9:658380. Published 2021 Sep 13. doi:10.3389/fbioe.2021.658380
24. Sgolastra F, Petrucci A, Severino M, Gatto R, Monaco A. Smoking and the risk of peri-implantitis. A systematic review and meta-analysis. Clin Oral Implants Res. 2015;26(4):e62-e67. doi:10.1111/clr.12333
25. Dhingra K, Jeng JH. Are partially edentulous patients with a history of severe periodontitis more prone to develop peri-implantitis over the long term?. Evid Based Dent. 2022;23(2):81-83. doi:10.1038/s41432-022-0269-4
26. Carcuac O, Jansson L. Peri-implantitis in a specialist clinic of periodontology. Clinical features and risk indicators. Swed Dent J. 2010;34(2):53-61.
27. Cho-Yan Lee J, Mattheos N, Nixon KC, Ivanovski S. Residual periodontal pockets are a risk indicator for peri-implantitis in patients treated for periodontitis. Clin Oral Implants Res. 2012;23(3):325-333. doi:10.1111/j.1600-0501.2011.02264.x
28. Moraschini V, Kischinhevsky ICC, Sartoretto SC, et al. Does implant location influence the risk of peri-implantitis?. Periodontol 2000. 2022;90(1):224-235. doi:10.1111/prd.12459
29. Vandeweghe S, Ferreira D, Vermeersch L, Mariën M, De Bruyn H. Long-term retrospective follow-up of turned and moderately rough implants in the edentulous jaw. Clin Oral Implants Res. 2016;27(4):421-426. doi:10.1111/clr.12602
30. Boronat A, Peñarrocha M, Carrillo C, Marti E. Marginal bone loss in dental implants subjected to early loading (6 to 8 weeks postplacement) with a retrospective short-term follow-up. J Oral Maxillofac Surg. 2008;66(2):246-250. doi:10.1016/j.joms.2007.09.016
31. Ozgur GO, Kazancioglu HO, Demirtas N, Deger S, Ak G. Risk Factors Associated With Implant Marginal Bone Loss: A Retrospective 6-Year Follow-Up Study. Implant Dent. 2016;25(1):122-127. doi:10.1097/ID.0000000000000366
32. Tawil G, Mawla M, Gottlow J. Clinical and radiographic evaluation of the 5-mm diameter regular-platform Brånemark fixture: 2- to 5-year follow-up. Clin Implant Dent Relat Res. 2002;4(1):16-26. doi:10.1111/j.1708-8208.2002.tb00147.x
33. Anderson N, Lords A, Laux R, Woodall W, Abubakr NH. Retrospective Analysis of the Risk Factors of Peri-implantitis. J Contemp Dent Pract. 2020;21(12):1350-1353. Published 2020 Dec 1.
34. Staubli N, Walter C, Schmidt JC, Weiger R, Zitzmann NU. Excess cement and the risk of peri-implant disease - a systematic review. Clin Oral Implants Res. 2017;28(10):1278-1290. doi:10.1111/clr.12954
35. Kesar N, Weigl P, Nentwig GH, Krebs M. Prevalence and risk of peri-implant diseases based on the type of prosthetic restoration: A retrospective study after 17 to 23 years. J Prosthet Dent. 2023;130(5):690-697. doi:10.1016/j.prosdent.2021.11.030
36. Grischke J, Szafrański SP, Muthukumarasamy U, Haeussler S, Stiesch M. Removable denture is a risk indicator for peri-implantitis and facilitates expansion of specific periodontopathogens: a cross-sectional study. BMC Oral Health. 2021;21(1):173. Published 2021 Apr 1. doi:10.1186/s12903-021-01529-9
37. Wada M, Mameno T, Onodera Y, Matsuda H, Daimon K, Ikebe K. Prevalence of peri-implant disease and risk indicators in a Japanese population with at least 3 years in function-A multicentre retrospective study. Clin Oral Implants Res. 2019;30(2):111-120. doi:10.1111/clr.13397
38. Hamed MT, Abdullah Mously H, Khalid Alamoudi S, Hossam Hashem AB, Hussein Naguib G. A Systematic Review of Screw versus Cement-Retained Fixed Implant Supported Reconstructions. Clin Cosmet Investig Dent. 2020;12:9-16. Published 2020 Jan 14. doi:10.2147/CCIDE.S231070
39. Zweers J, van Doornik A, Hogendorf EA, Quirynen M, Van der Weijden GA. Clinical and radiographic evaluation of narrow- vs. regular-diameter dental implants: a 3-year follow-up. A retrospective study. Clin Oral Implants Res. 2015;26(2):149-156. doi:10.1111/clr.12309
40. Corcuera-Flores JR, Pérez-Fierro M, Blanco-Carrión A, Torres-Lagares D, Castellanos-Cosano L, Machuca-Portillo G. Bone loss around narrow implants versus standard diameter implants: Retrospective 2-years case-control study. J Clin Exp Dent. 2020;12(1):e79-e84. Published 2020 Jan 1. doi:10.4317/medoral.56422
41. Jung RE, Al-Nawas B, Araujo M, et al. Group 1 ITI Consensus Report: The influence of implant length and design and medications on clinical and patient-reported outcomes. Clin Oral Implants Res. 2018;29 Suppl 16:69-77. doi:10.1111/clr.13342
42. Carvalho W, Casado PL, Caúla AL, Barboza EP. Implants for single first molar replacement: important treatment concerns. Implant Dent. 2004;13(4):328-335. doi:10.1097/01.id.0000148558.80761.bf
43. Galindo-Moreno P, Fernández-Jiménez A, Avila-Ortiz G, Silvestre FJ, Hernández-Cortés P, Wang HL. Marginal bone loss around implants placed in maxillary native bone or grafted sinuses: a retrospective cohort study. Clin Oral Implants Res. 2014;25(3):378-384. doi:10.1111/clr.12122
44. Barone A, Orlando B, Cingano L, Marconcini S, Derchi G, Covani U. A randomized clinical trial to evaluate and compare implants placed in augmented versus non-augmented extraction sockets: 3-year results. J Periodontol. 2012;83(7):836-846. doi:10.1902/jop.2011.110205