Crestal bone changes at teeth and implants in periodontally healthy and periodontally compromised patients. A 10-year comparative case-series study.
BACKGROUND
Limited data exist on the longitudinal crestal bone changes around teeth compared with implants in partially edentulous patients. This study sought to compare the 10-year radiographic crestal bone changes (bone level [BL]) around teeth and implants in periodontally compromised (PCPs) and periodontally healthy (PHPs) patients.


METHODS
A total of 120 patients were evaluated for the radiographic crestal BL around dental implants and adjacent teeth at time of implant crown insertion and at the 10-year follow-up. Sixty patients had a previous history of periodontitis (PCPs), and the remaining 60 were PHPs. In each category (PCP and PHP), two different implant systems were used. The mean BL change at the implant and at the adjacent tooth at the interproximal area was calculated by subtracting the radiographic crestal BL at the time of crown cementation from the radiographic crestal BL at the 10-year follow-up.


RESULTS
At 10 years after therapy, the survival rate ranged from 80% to 95% for subgroups for implants, whereas it was 100% for the adjacent teeth. In all eight different patient categories evaluated, teeth demonstrated a significantly more stable radiographic BL compared with adjacent dental implants (teeth BL, 0.44 ± 0.23 mm; implant BL, 2.28 ± 0.72 mm; P <0.05). Radiographic BL changes around teeth seemed not to be influenced by the presence or absence of advanced bone loss (≥3 mm) at the adjacent implants.


CONCLUSIONS
Natural teeth yielded better long-term results with respect to survival rate and marginal BL changes compared with dental implants. Moreover, these findings also extend to teeth with an initial reduced periodontal attachment level, provided adequate periodontal treatment and maintenance are performed. As a consequence, the decision of tooth extraction attributable to periodontal reasons in favor of a dental implant should be carefully considered in partially edentulous patients.
Department of Biomedical, Surgical, and Dental Sciences, Unit of Periodontology, Istituti di Ricovero e Cura a Carattere Scientifico (IRCC), University of Milan, Milan, Italy.
Giulio
G
Rasperini
Vincenzo Iorio
VI
Siciliano
Carlo
C
Cafiero
Giovanni E
GE
Salvi
Andrea
A
Blasi
Marco
M
Aglietta
D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging; D000539:Alveolar Process / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D003442:Crowns; D015921:Dental Implants; D017267:Dental Prosthesis Design; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000000981:diagnostic imaging / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000000981:diagnostic imaging / Q000517:prevention & control; D010518:Periodontitis / Q000000981:diagnostic imaging* / Q000517:prevention & control; D010519:Periodontium / Q000000981:diagnostic imaging*; D011859:Radiography; D012189:Retrospective Studies; D012907:Smoking; D014070:Tooth / Q000000981:diagnostic imaging*
D015921:Dental Implants
Alveolar bone loss; peri-implantitis; periodontitis; smoking