Page 34 - Peri-implant health: the effect of implant design and surgical procedure on bone and soft tissue stability

CHAPTER 3
Zitzmann and Berglundh based on only two cross‐sectional studies reported 28–77% on patient level and 12–43% on implant sites with peri‐implantitis.70 Mombelli, Muller and Cionca calculated the prevalence of peri‐implantitis, based on 29 papers, in the order of 10% of the affected implants and 20% patients during 5–10 years after implant placement.71 Another review summarizing 10 papers reporting on the 10‐year clinical outcome with implants treated by sandblasting, grit blasting, acid‐etching, or combined treatments revealed that the survival was above 95% and < 5% were diagnosed with purulent infection or peri‐implantitis.72 A 10‐year follow‐up study including nearly 300 implants in 100 subjects revealed similar figures.73 They concluded that implant sites with radiographically confirmed marginal bone loss of ≥ 1 mm were not common and that peri‐implantitis defined as bone loss > 0.5 mm, BoP+, and PD ≥ 6 mm was detected in 12% of patients and only 5% of implants. Atieh and colleagues performed a systematic review including information of 1,497 patients with 6,283 implants and reported a respective prevalence of 18.8% on patient level and 9.6% on implant level.74 Derks and Tomasi performed a systematic review including 11 clinical studies and reported a broad range in the prevalence of peri‐implant mucositis (19%–65%) and peri‐implantitis (1%–47%).19 The meta‐ analyses estimated a weighted mean prevalence of peri‐implantitis affecting 22% of the implants. The meta‐regression showed a positive relationship between prevalence of peri‐implantitis and function time. This report was critically appraised in a paper by Jemt, mentioning that the broad range in the prevalence could be attained to different thresholds for bone loss (range 0.4 mm - 5 mm) used in the various case definition applied in the selected papers, in combination with a high dropout rate and the use of bone levels at a cross‐sectional time point instead of absolute bone loss.75 The systematic review of Lee and colleagues included 47 studies whereby the bone level thresholds for disease ranged from 1 to 5 mm and lead to a weighted mean implant‐based and subject‐based peri‐implantitis of 9.2% and 19.8%, respectively.61
Aim
The aim of this critical review was to describe whether the commonly used biologic diagnostic parameters correspond to long‐term outcome in terms of implant survival and reported peri‐implantitis prevalence.
32