Influence of inflammatory reactions vs. occlusal loading on peri-implant marginal bone level.
Plaque accumulation on abutments or implant surfaces induces an inflammatory reaction in the gingiva/alveolar mucosa just as around teeth. The longevity of oral implants can be jeopardized by either peri-implantitis and/or an occlusal overload. In the partially edentulous patient in whom pockets around teeth act as a reservoir for the colonization of the pockets around implants, the risk for inflammatory reactions of the peri-implant soft tissues seems especially more plausible than in the fully edentulous patient. This is especially true for implants with a very rough surface (e.g., plasma-sprayed), because of the positive relationship between surface roughness and supra- as well as subgingival plaque formation. Several medium-term (from 5 to 10 years) clinical studies support this hypothesis, through the observation of ongoing bone loss and subsequent decreasing success/survival percentages. Occlusal overload increases the risk for microfractures at the implant-bone interface in two-stage implants, which can result in significant marginal bone loss and even failure. There is ample evidence that occlusal factors are related to marginal angular defects around two-stage implants.
van Steenberghe
D
D
Department of Periodontology, Catholic University Leuven, Faculty of Medicine, School of Dentistry, Oral Pathology and Maxillo-Facial Surgery, Kapucijnenvoer 33, B-3000 Leuven, Belgium.
Naert
I
I
Jacobs
R
R
Quirynen
M
M
D016301:Alveolar Bone Loss / Q000209:etiology* / Q000382:microbiology; D000539:Alveolar Process / Q000503:physiopathology*; D001732:Bite Force; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D003773:Dental Plaque / Q000150:complications / Q000382:microbiology; D019232:Dental Restoration Failure; D005891:Gingivitis / Q000209:etiology; D006801:Humans; D016348:Osseointegration; D010514:Periodontal Pocket / Q000382:microbiology; D010518:Periodontitis / Q000209:etiology* / Q000382:microbiology; D012307:Risk Factors; D013499:Surface Properties
D015921:Dental Implants