Page 37 - 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
nine treatment groups, the reported implant survival rate was ranging between 95.0%–100% and 90.0%–94.9%, respectively. Only one treatment group reported an implant survival below 90%. The weighted mean follow‐up time for the 56 treatment groups was 9.0 years with a range of 3–24.4 years. The weighted mean follow‐up was 9.2 (3–24.4) and 8.7 (5–21) years for retrospective and prospective groups, respectively. Thirty of the 56 treatment groups, representing initially 5,886 implants, had a follow‐up time between 5 and 9.9 years with 4,894 implants at follow‐up (dropout 16.9%). In total, 24 treatment groups had a mean follow‐up time ranging between 10 and 14.9 years, with 3,498 implants at baseline and 3,025 implants at follow‐up (dropout 13.5%). Only two treatment groups had a mean follow‐up time of 15 years or longer, with 273 implants at baseline and 263 at follow‐up (dropout rate of 3.7%).
Reported prevalence and case definition of peri‐implantitis
For all the included 56 treatment groups, the prevalence of peri‐implantitis on implant level ranged between 0% and 39.7% as shown in Table 1 and was based on 15 different case definitions of peri‐implantitis. The case definitions varied considerably, mostly due to heterogeneous thresholds for bone loss and ranging from any detectable bone loss to 3.5 mm. Of the 41 papers, only 27 had a clearly defined threshold for bone loss, most commonly 2 mm. Some authors used more than one threshold and also gave more than one prevalence.76-78 Tey and colleagues made a distinction between clinical peri‐implant disease definitions according to Pjetursson et al. and the prevalence of peri‐implantitis based on radiographic diagnosis.78,79 Derks and colleagues used a combination of BoP and/or suppuration with a bone loss threshold of 0.5 mm and diagnosed 24.9% with peri‐implantitis.76 However, when they used a bone loss threshold of 2.0 mm, only 7.8% of the implants were diagnosed with peri‐implantitis. Also, Donati used two different bone loss thresholds.77 Peri‐implantitis was diagnosed in 2.9% or 5.7% of the implants when applying 2 or 1 mm thresholds for bone loss, respectively. The highest prevalence of peri‐implantitis (although coined incidence in the paper) was found in the study by Renvert, Lindahl and Rutger Persson, originally reporting on 234 implants of two different brands after 7 years of function in 54 patients.80 After 13 years, 164 implants were available for radiographic evaluation, which resulted in a dropout rate of 29.9% on implant level. The mean bone loss for the two study groups was 0.8 mm and 1.0 mm, respectively. Peri‐implantitis was detected in nearly 40% of the implants based on a bone loss threshold above 1 mm following the first year after implant placement.
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