Clinical and microbiological determinants of ailing dental implants.
BACKGROUND
The failure of the host tissue to establish or maintain osseointegration around dental implants is due to either occlusal or parafunctional forces, premature loading, ill-directed stress, or microbial infection. The long-term failure rate of dental implants is generally 5-10%. Although a variety of etiologies of early peri-implant bone loss (from implant placement to 1-year post-loading) have been proposed, factors associated with late implant failures are less well understood but are probably related to both the peri-implant microbial environment and host factors. Discriminating between causes of implant failure is of importance for instituting a successful implant therapy.


OBJECTIVE
The objective of this cross-sectional split-mouth study was to identify clinical, radiographic, and bacterial characteristics of peri-implant disease sites.


METHODS
Fifteen patients with bilateral implants (Brånemark, Nobel Biocare AB, Göteborg, Sweden; and 3i implant systems, Implant Innovations Inc., Palm Beach Gardens, FL, USA) participated in the study. Sites with peri-implant (radiographic bone loss beyond the third implant thread) and peri-implant healthy tissues (radiographic bone level above the first implant thread) were identified in periapical radiographs using a long-cone paralleling projection technique. Microbiological identification was carried out using established anaerobic culture techniques. A descriptive statistics based on means and standard deviations was reported.


RESULTS
Peri-implant bone loss was associated with the absence of radiographic crestal lamina dura, peri-implant pocket depth, pain on chewing, and the submucosal presence of the putative periodontopathogens Tannerella forsythia, Campylobacter species, and Peptostreptococcus micros. Pain was associated with P. micros, Fusobacterium species, and Eubacterium species.


CONCLUSIONS
The absence of radiographic crestal lamina dura and the presence of suspected major periodontal pathogens seem to be associated to peri-implantitis.
Tabanella
Giorgio
G
Advanced periodontics, University of Southern California School of Dentistry, Los Angeles, CA, USA. giorgio.tabanella@usc.edu
Nowzari
Hessam
H
Slots
Jorgen
J
D000328:Adult; D000368:Aged; D010520:Aggressive Periodontitis / Q000209:etiology; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology / Q000382:microbiology; D001421:Bacteria, Anaerobic / Q000302:isolation & purification; D001439:Bacteroides / Q000302:isolation & purification; D002167:Campylobacter / Q000302:isolation & purification; D055113:Chronic Periodontitis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000382:microbiology; D003430:Cross-Sectional Studies; D015921:Dental Implants / Q000009:adverse effects* / Q000382:microbiology; D003774:Dental Plaque Index; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D003828:Denture, Overlay; D003830:Denture, Partial, Fixed; D005051:Eubacterium / Q000302:isolation & purification; D005260:Female; D005673:Fusobacterium / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D010462:Peptostreptococcus / Q000302:isolation & purification; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000000981:diagnostic imaging / Q000209:etiology / Q000382:microbiology; D011859:Radiography
D015921:Dental Implants