Page 200 - Peri-implant health: the effect of implant design and surgical procedure on bone and soft tissue stability
P. 200

                                CHAPTER 8
compliance is taken care of, it is to be expected that further bone level changes related to the implant design are limited.
Another limitation in the clinical trials presented in this thesis is the number of included patients. This number is often limited because of financial reasons. On the other hand, the follow-up time and number of patients in Study III, IV and V are comparable to samples included in other papers in the field.36-39 Moreover, the applied split-mouth design of the studies may help to minimize the afore- mentioned limitations.
■ GENERALCONCLUSIONS
1. Various peri-implantitis definitions are used in the literature, and reporting of biological parameters is often incomplete. Consistent reporting of peri- implantitis is required for scientific purposes as well as for clinical practice.
2. The peri-implantitis prevalence based on various case definitions did not correlate with the diagnostic parameters ‘mean probing pocket depth’, ‘mean bleeding on probing’, and ‘mean bone loss’. The survival rate showed a substantial correlation with function time, but implant loss over time is low.
3. In the current literature, less than 5% of the implants showed bone loss above 3 mm after at least five years in function. This result was independent of surface or implant brand, suggesting that currently reported peri- implantitis prevalence is exaggerated.
4. Rough implant systems are more prone to crestal bone loss. However, the multifactorial cause for bone loss and the heterogeneity of the studies make it difficult to draw firm conclusions. Nevertheless, more papers show less bone loss in favour of minimally rough implant systems.
5. Co-factors such as smoking or a history of periodontal disease increase the risk of bone loss.
6. The implant neck design (microthreaded vs non-microthreaded) has no influence on peri-implant bone remodeling when implants are installed in relation to soft tissue thickness allowing the formation of a 3 to 4 mm biological seal.
7. The implant-abutment connection type (internal vs external) has no
198























































































   198   199   200   201   202