title: Stress and inflammation as a detrimental combination for peri-implant bone loss.
abstract: The causes of peri-implant bone loss continue to be controversial. To determine the impact of biomechanical stress and inflammation, we investigated a total of 80 interforaminal implants in situ for more than 10 years. Two stress groups, with 14 patients each, were established: a low-stress situation with single-standing implants, and an increased-stress situation with splinted implants. To categorize inflammation, we introduced a Composite Inflammation Score using 4 inflammatory parameters. Peri-implant bone loss was calculated from digital panoramic radiographs. To differentiate between the effects of stress and inflammation, we compared bone loss in both stress groups at equivalent levels of inflammation. With greater Composite Inflammation Score values, a clear discrepancy between single-standing and splinted implants was evident (p = 0.117/0.000, regression analysis; p = 0.135/0.000, analysis of variance; p = 0.002, t tests). While stress and inflammation alone may not necessarily be detrimental factors, the presence of stress heightens peri-implant bone loss significantly as inflammation increases.
authors.affiliation: School of Dental Medicine, University of Erlangen-Nuremberg, Glückstr. 11, 91054 Erlangen, Germany. Siegfried.Heckmann@zp.med.uni-erlangen.de
authors.forename: S M
authors.initials: SM
authors.lastname: Heckmann
authors.forename: J J
authors.initials: JJ
authors.lastname: Linke
authors.forename: F
authors.initials: F
authors.lastname: Graef
authors.forename: Ch
authors.initials: Ch
authors.lastname: Foitzik
authors.forename: M G
authors.initials: MG
authors.lastname: Wichmann
authors.forename: H-P
authors.initials: HP
authors.lastname: Weber
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology*; D000704:Analysis of Variance; D003758:Dental Implantation, Endosseous / Q000009:adverse effects; D015921:Dental Implants / Q000009:adverse effects*; D017267:Dental Prosthesis Design / Q000009:adverse effects*; D019094:Dental Prosthesis, Implant-Supported / Q000009:adverse effects*; D005260:Female; D005883:Gingival Crevicular Fluid / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000737:chemistry; D010512:Periodontal Index; D010518:Periodontitis / Q000150:complications*; D011859:Radiography; D012044:Regression Analysis; D013314:Stress, Mechanical
chemical_list: D015921:Dental Implants