title: Marginal bone loss as success criterion in implant dentistry: beyond 2 mm.
abstract: OBJECTIVE
  The aim of this study was to analyze marginal bone loss (MBL) rates around implants to establish the difference between physiological bone loss and bone loss due to peri-implantitis.
  
  
  METHODS
  Five hundred and eight implants were placed in the posterior maxilla in 208 patients. Data were gathered on age, gender, bone substratum (grafted or pristine), prosthetic connection, smoking and alcohol habits, and previous periodontitis. MBL was radiographically analyzed in three time frames (5 months post-surgery and at 6 and 18 months post-loading). Nonparametric receiver operating curve (ROC) analysis and mixed linear model analysis were used to determine whether implants could be classified as high or low bone loser type (BLT) and to establish the influence of this factor on MBL rates.
  
  
  RESULTS
  Marginal bone loss rates were significantly affected by BLT, connection type, bone substratum, and smoking. Bone loss rates at 18 months were associated with initial bone loss rates: 96% of implants with an MBL of >2 mm at 18 months had lost 0.44 mm or more at 6 months post-loading.
  
  
  CONCLUSIONS
  Implants with increased MBL rates at early stages (healing and immediate post-loading periods) are likely to reach MBL values that compromise their final outcome. Initial (healing, immediate post-loading) MBL rates around an implant of more than 0.44 mm/year are an indication of peri-implant bone loss progression.
authors.affiliation: Oral Surgery and Implant Dentistry Department, School of Dentistry, University of Granada, Granada, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Galindo-Moreno
authors.affiliation: Oral Surgery and Implant Dentistry Department, School of Dentistry, University of Granada, Granada, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: León-Cano
authors.affiliation: Oral Surgery and Implant Dentistry Department, School of Dentistry, University of Granada, Granada, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Ortega-Oller
authors.affiliation: Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, USA.
authors.forename: Alberto
authors.initials: A
authors.lastname: Monje
authors.affiliation: Department of Pathology, School of Medicine & IBIMER, University of Granada, Granada, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: O Valle
authors.affiliation: Department of Experimental Psychology, School of Psychology, University of Granada, Granada, Spain.
authors.forename: Andrés
authors.initials: A
authors.lastname: Catena
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology*; D018786:Bone Substitutes / Q000627:therapeutic use; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging / Q000601:surgery; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use; D057873:Peri-Implantitis / Q000150:complications* / Q000000981:diagnostic imaging; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: C077540:Bio-Oss; D018786:Bone Substitutes; D015921:Dental Implants; D008903:Minerals
keywords: alveolar bone loss; dental implant; dental implant-abutment connection; marginal bone loss; maxillary sinus augmentation; peri-implantitis