Page 35 - Peri-implant health: the effect of implant design and surgical procedure on bone and soft tissue stability

HOW DO PERI-IMPLANT BIOLOGIC PARAMETERS CORRESPOND WITH IMPLANT SURVIVAL AND PERI-IMPLANTITIS? A CRITICAL REVIEW
■ MATERIALANDMETHODS
Search strategy
The focus of this study was on diagnostic aspects in relation to peri‐implant health and clinical outcome in long‐term perspective. Given the overall consensus that progressive bone loss is the most important biologic parameter in the diagnosis of peri‐implantitis, it was decided to conduct a broad literature search using Pubmed database of the US National Library of Medicine for articles. Publications from 2011 up to September 2017 were selected using the general search algorithm: ((((((“bone loss”) OR “peri‐implantitis”)) OR “periimplant”)) AND dental implant). Cross‐sectional reports were excluded because they report on bone levels and not on bone loss. The papers had to be published in English, report on peri‐implantitis prevalence together with mean bone loss on implant level (compared to a baseline measurement). No distinction was made based on study design (prospective or retrospective, RCT, or case series) or surgical or prosthetic treatment protocol as long as they included at least 10 patients after a minimal mean follow‐up time of 5 years. Only studies discussing implant treatment in systemically healthy patients were included, but studies with smokers, patients with periodontal history, controlled diabetes, or implants in sinus lifted bone were allowed. Studies describing implant treatment in tumor‐resected areas, studies involving extensive bone grafts or zygomatic or mini‐implants were excluded. An independent selection was performed based on the title and detailed information given in the abstract by two assessors (RD & HDB) who discussed jointly and reached a consensus in case of disagreement over the inclusion/exclusion of a paper.
Data analysis
Papers were descriptively analyzed, and case definitions of peri‐implantitis were extracted. Analysis was performed on implant level. In the overall statistical analysis of implant survival and bone loss, the number of implants was used to weight the study or study groups throughout this review. A bivariate correlation analysis was performed using the Pearson r correlation coefficient. A correlation coefficient ranging from 0.01–0.19, 0.20–0.29, 0.30–0.39, 0.40–0.69, and above 0.70 represent a negligible, weak, moderate, strong, and very strong relationship, respectively. Correlation was calculated between the outcomes (i) reported prevalence of peri‐implantitis and (ii) mean implant survival, mean time in function, mean
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