Page 211 - Peri-implant health: the effect of implant design and surgical procedure on bone and soft tissue stability

■ SUMMARY
Over the last decade, the focus of clinical implant research shifted from predominately survival orientated to peri-implant health and patient-centred outcomes. A stable peri-implant bone level is a prerequisite to achieve long-term implant success. Peri-implant bone level is affected by patient-, implant-, and site- specific factors. In addition, the success of an implant treatment could also be determined by the improvement in Oral Health-Related Quality of Life (OHRQoL). The introduction (Chapter 1) scrutinizes and clarifies the current literature focusing on these factors. The existing literature gives an ambiguous effect of implant- related and site-specific factors on peri-implant bone stability, showing the need for more research.
Chapter 2 presents the aims of this dissertation. This thesis’s first two literature studies (Chapter 3 and 4) systematically assessed the available scientific evidence. The assessment focused on whether commonly used biological parameters correspond to long-term outcomes of implant survival and reported peri-implantitis prevalence. Additionally, it also examined whether long-term peri-implant bone loss is affected by implant surface roughness. The clinical studies in this thesis (Chapter 5, 6, and 7) aimed to evaluate the effect of implant related factors such as implant micro-design (implant surface roughness), macro-design (microthreads and implant-abutment connection), and site- specific factors (soft-tissue thickness) on long-term peri-implant bone stability and peri-implant health. Additionally, we paid attention to the Oral Health-Related Quality of Life in patients restored with mandibular implant-retained overdentures.
Chapter 3 (Study I) is a critical review of the literature published between 2011 and 2017, regarding the biological peri-implant parameters bleeding on probing, probing pocket depth, and bone loss. The search algorithm highlighted 4,173 papers available for further analysis, 255 papers for full article reading, and 41 fulfilled the inclusion criteria. In these 41 articles, 15 different case definitions for peri-implantitis were used. The reported prevalence of peri-implantitis ranged between 0% and 39.7%, with an overall mean weighted implant survival rate of 96.9% (89.9% - 100%).
SUMMARY IN ENGLISH
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