Page 186 - Peri-implant health: the effect of implant design and surgical procedure on bone and soft tissue stability

CHAPTER 8
This thesis discussed how peri-implant health could be affected by patient-, implant and site-specific factors. Peri-implant health is reflected by peri-implant bone stability. The stability of peri-implant bone is considered a crucial factor for implant success. The available scientific evidence was assessed systematically (STUDY I AND II, CHAPTER 3 AND 4), focussing on the long-term effect of implant surface roughness and patient’ factors on crestal bone loss. In addition, we assessed how peri-implant biologic parameters correspond with implant survival and peri-implantitis diagnosis. Only studies with at least five years of follow-up were included because peri-implantitis is more likely to occur after a few years of function and exposure to bacterial load. The three clinical studies (STUDY III, IV, AND V, CHAPTER 5, 6, AND 7) scrutinized the effect of implant macro- and micro design, and the surgical procedure on peri-implant bone and soft tissue stability. In Study III and IV (CHAPTER 5 AND 6) the patient-reported outcome related to quality of life was reported.
The three clinical studies were a collaborative multidisciplinary research effort. Short-term data about implant survival and peri-implant health were previously published within the research group regarding surgical aspects. 1-3 Moreover, the group has published studies on prosthetic-related aspects, including cost- effectiveness, patient-related outcome, prosthetic aftercare,4 and patient-related outcome measures reflecting on oral-health related quality of life and speech.5,6
Diagnostic Criteria to Describe Clinical Implant Outcome
Study I focused on the large variability in case definition of per-implantitis. Furthermore, the prevalence of peri-implant mucositis and peri-implantitis in the existing literature is examined. To reflect daily clinical practice and to be as inclusive as feasible, not only well-controlled academic studies, but all types of studies were included. With the used search algorithm, 4,173 papers were found between 2011 and 2017, of which 255 were selected for further assessment. Unfortunately, only 41 could be included for further analysis. This is a low proportion, given the significant impact it has on patients and clinicians. From 2011 to 2017 as many papers appeared as in the previous 35 years, which is indicative for the growing scientific interest for peri-implant health and disease. The scientific interest is apparently still growing, because more papers were published in 2020 compared to 2017. This rise in interest is probably caused by the increase in the use of dental implants in daily clinical practice. Study I delved
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