Reliability of findings around healthy implants in association with oral hygiene measures: a clinical, microbiological, and immunological follow-up in edentulous patients.
OBJECTIVE
To assess the performance of clinical, microbiological, and immunological diagnosis of peri-implant health and the influence of professional hygiene measures on them.


METHODS
Twenty-one edentulous patients with oral implants supporting a lower overdenture were followed up over 3 months beginning 1 week before their annual recall visit. Hygiene scores, probing depth, bleeding on probing (BOP), implant stability, gingival crevicular fluid (GCF) volume, sulcular interleukin-1beta (IL-1beta) and prostaglandin E2 (PGE2) concentrations, and relative concentrations of five bacterial species (polymerase chain reaction) were investigated. Measurement variation was assessed as a function of (a) intra- and (b) inter-examiner reliability, (c) inter-implant variation in each patient, (d) time, and (e) effect of hygiene measures by accuracy, repeatability, reproducibility, and visualization with the Bland and Altman Plot.


RESULTS
Measurement means and accuracy (in parentheses) were as follows: GCF volume 1.5 microl (1.5), Interleukin-1beta 8 ng/ml (26), PGE2 63 ng/ml (185), bacteria sum score 0.2 (0.7), plaque score 1 (1), BOP score 0 (1), Periotest value -4 (3), resonance frequency analysis ISQ 66 (11), and pocket probing depth 2.3 mm (0.7). No finding exhibited any statistically significant measurement variation as explained by accuracy, repeatability, or reproducibility. Bland and Altman Plots revealed insufficient agreement for replicated BOP assessments. A short post-treatment reduction in plaque and BOP scores was visually apparent. Still, professional oral hygiene measures exerted no sustained influence on the clinical and biochemical appearance of the peri-implant tissues.


CONCLUSIONS
All findings except BOP showed statistically acceptable repeatability and moderate vulnerability to influences present 'chairside' in clinical practice.
Lachmann
Stefan
S
Department of Oral Surgery, Bernhard Gottlieb University Dental School, Medical University of Vienna, Vienna, Austria. stefan.lachmann@med.uni-tuebingen.de
Kimmerle-Müller
Evi
E
Axmann
Detlef
D
Gomez-Roman
German
G
Weber
Heiner
H
Haas
Robert
R
D000368:Aged; D015169:Colony Count, Microbial; D015921:Dental Implants / Q000009:adverse effects* / Q000382:microbiology; D019094:Dental Prosthesis, Implant-Supported / Q000009:adverse effects* / Q000382:microbiology; D003828:Denture, Overlay / Q000009:adverse effects* / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D005883:Gingival Crevicular Fluid / Q000276:immunology / Q000382:microbiology / Q000502:physiology; D006801:Humans; D053583:Interleukin-1beta / Q000032:analysis; D007575:Jaw, Edentulous / Q000382:microbiology / Q000534:rehabilitation / Q000601:surgery; D008297:Male; D015588:Observer Variation; D009910:Oral Hygiene; D010512:Periodontal Index; D010518:Periodontitis / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology / Q000382:microbiology; D011446:Prospective Studies; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric
D015921:Dental Implants; D053583:Interleukin-1beta