(18) Peri-implantitis Prevalence and Effect of periodontal implant maintenance therapy on Outcomes

Introduction: Tissue and tooth-supported prostheses were the primary treatment of choice to restore completely and partially edentulous cases in the past. The advent of dental implants enabled dentists to replace missing teeth with implant-supported prostheses. The implantation and replacement of natural dentition with dental implants have been highly successful. These prosthetic substitutes suffer from a very similar disease to their natural counterpart. Despite how dental implants have transformed the reconstructive options, the current endemic of peri-implantitis has severely compromised the long-term success of implant dentistry. Management of peri-implantitis is becoming an increasing component of dental practice. Dental implants can develop peri-implantitis lesions which occur in a non‐linear and accelerating pattern compared to a gradual periodontitis lesion. It is crucial to diagnose and treat this disease early, or ideally prevent it. Contemporary implants have a rough surface texture which is difficult to properly decontaminate as a crucial component for treatment prognosis. Evidence on the long-term effects of Periodontal implant maintenance therapy (PIMT) on implants is limited. This study aims to investigate the effect of periodontal maintenance on peri-implant tissue health.

Methods: A retrospective chart review was conducted at residency clinics on patients who underwent implant therapy with 1-7 years of follow-up. Outcome variables of interest were peri-implantitis and early implant failure. Predictors included PIMT frequency, implant characteristics, and demographics. The associations between implant failure, peri-implantitis, and PIMT frequency were assessed using Fisher’s Exact test. The significance level was set at 0.05.

Results: A total of 368 patient records & 497 implants were included in the study. Of those, 20 (7%) demonstrated peri-implantitis, and 16 (6%) had early implant failure. There was a significant association between recall periodontal maintenance and peri-implantitis (p-value=0.0169). The rate of peri-implantitis was 12% (n=14) for those with no recall and 4% (n=6) for those with recall. Early implant failure was also significantly associated with peri-implantitis, with 25% of those with peri-implantitis experiencing early failure compared to 4% of those who did not (p-value=0.0062). The recall was not significantly associated with early implant failure (p-value=0.4372).

Conclusions: PIMT frequency was associated with implant failure and peri-implantitis in an academic setting, within the limitations of this study.

Lead Author's Contributions to the Research Project. : Primary data collector and writer.