Page 116 - Peri-implant health: the effect of implant design and surgical procedure on bone and soft tissue stability

CHAPTER 5
De Bruyn and co-workers also concluded that patient satisfaction is highly individual and satisfaction with an implant-supported overdenture is never guaranteed. Hence, the decision to propose an implant-supported overdenture should be based on proper individual assessment.7
Despite the improvement of the patient’s quality of life and high survival and success rates of dental implants in patients with overdentures, dental implants are not free of complications. The most common complications following implant therapy are peri-implant mucositis (bleeding on probing and inflammation of the peri-implant soft tissues), and peri-implantitis (clinical and radiographic bone loss with or without suppuration). To detect inflammatory changes around the implant, several biologic parameters (plaque, bleeding, and suppuration) must be monitored during the patient’s follow-up visits.11
According to the latest consensus report of the“WorldWorkshop on the Classification of Periodontal and Peri-implant Diseases and Conditions”, the main clinical characteristic of peri-implant mucositis is bleeding on gently probing.12 Erythema, swelling, and/or suppuration may also be present.13 There is strong evidence from animal and human experimental studies that plaque is the etiological factor for peri-implant mucositis.11,14-18 Peri-implantitis is described as a plaque-associated pathologic condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone. Peri-implantitis sites exhibit clinical signs of inflammation, bleeding on probing, and/or suppuration, increased probing depths and/or recession of the mucosal margin in addition to radiographic bone loss.19 Peri- implantitis is a consequence of crestal bone loss. Two recent consensus meetings highlighted the influence of implant material, shape and surface characteristics on the occurrence and progression of peri-implantitis. However, evidence for these suggestions is weak and future long-term studies are necessary to analyze these potential risk factors.20,21 Beside these implant factors also other important factors like surgical, prosthetic, patient-related factors and foreign body reactions may contribute to crestal bone loss.21
The composition and the topography of the implant surface have been a matter of debate during the last decades. Both composition and topography have their influence on implant surface roughness. The implant surface roughness
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