Prevalence and risk indicators of peri-implantitis in Korean patients with a history of periodontal disease: a cross-sectional study

PURPOSE: The aim of this study was to analyze the prevalence and risk indicators of peri-implantitis in Korean patients with history of periodontal disease. METHODS: A total of 444 patients with 1,485 implants were selected from patients who had been treated at the Department of Periodontology, Chonbuk National University Dental Hospital between July 2014 and June 2015. A group with a history of peri-implantitis (HP) (370 patients with 1,189 implants) and a group with a current peri-implantitis (CP) (318 patients with 1,004 implants) were created based on the radiographic and clinical assessments of implants. The prevalence of peri-implantitis was calculated at both the patient and implant levels. The influence of risk variables on the occurrence of peri-implantitis was analyzed using generalized estimating equations analysis. RESULTS: The prevalence of peri-implantitis in the HP and CP groups ranged from 6.7% to 19.7%. The cumulative peri-implantitis rate in the HP group estimated with the Kaplan-Meier method was higher than that in the CP group over the follow-up period. Among the patient-related risk variables, supportive periodontal therapy (SPT) was the only significant risk indicator for the occurrence of peri-implantitis in both groups. In the analysis of implant-related variables, implants supporting fixed dental prosthesis (FDP) and implants with subjective discomfort were associated with a higher prevalence of peri-implantitis than single implants and implants without subjective discomfort in the HP group. The presence of subjective discomfort was the only significant implant-related variable predictive of peri-implantitis in the CP group. CONCLUSIONS: Within the limitations of this study, the prevalence of peri-implantitis in Korean patients with a history of periodontal disease was similar to that reported in other population samples. Regular SPT was important for preventing peri-implantitis. Single implants were found to be less susceptible to peri-implantitis than those supporting FDP. Patients' subjective discomfort was found to be a strong risk indicator for peri-implantitis.

Alterations of papilla dimensions after orthodontic closure of the maxillary midline diastema: a retrospective longitudinal study

PURPOSE: The aim of this study was to evaluate alterations of papilla dimensions after orthodontic closure of the diastema between maxillary central incisors. METHODS: Sixty patients who had a visible diastema between maxillary central incisors that had been closed by orthodontic approximation were selected for this study. Various papilla dimensions were assessed on clinical photographs and study models before the orthodontic treatment and at the follow-up examination after closure of the diastema. Influences of the variables assessed before orthodontic treatment on the alterations of papilla height (PH) and papilla base thickness (PBT) were evaluated by univariate regression analysis. To analyze potential influences of the 3-dimensional papilla dimensions before orthodontic treatment on the alterations of PH and PBT, a multiple regression model was formulated including the 3-dimensional papilla dimensions as predictor variables. RESULTS: On average, PH decreased by 0.80 mm and PBT increased after orthodontic closure of the diastema (P<0.01). Univariate regression analysis revealed that the PH (P=0.002) and PBT (P=0.047) before orthodontic treatment influenced the alteration of PH. With respect to the alteration of PBT, the diastema width (P=0.045) and PBT (P=0.000) were found to be influential factors. PBT before the orthodontic treatment significantly influenced the alteration of PBT in the multiple regression model. CONCLUSIONS: PH decreased but PBT increased after orthodontic closure of the diastema. The papilla dimensions before orthodontic treatment influenced the alterations of PH and PBT after closure of the diastema. The PBT increased more when the diastema width before the orthodontic treatment was larger.

Analysis of the embrasure dimensions between maxillary central incisors in relation to the topography of the interdental papilla

PURPOSE: To analyze the dimensions of the embrasure space between the maxillary central incisors as potential factors influencing interdental papilla fill and height. METHODS: The embrasure dimensions between the maxillary central incisors of 100 subjects (40 females/60 males) were assessed with clinical, study model, and radiographic examinations. Variables of the complete and deficient papilla fill groups were compared. Multiple regression analyses were performed to investigate potential influence of the distance between the contact point and bone crest (CP_BC), horizontal interdental distance (HID), and facio-lingual thickness (FLT) at the papilla base on complete/deficient papilla fill and papilla height (PH). RESULTS: CP_BC was the only variable that showed a significant difference between the complete and deficient papilla groups (P<0.05). When the CP_BC was less than 5 mm, the embrasure spaces between the maxillary central incisors were completely filled with interdental papilla. Multiple regression analyses revealed that a significant predictor for complete/deficient papilla fill was CP_BC, and significant predictors for PH were CP_BC and HID (P<0.05). CONCLUSIONS: The chances of complete papilla fill increased as CP_BC decreased, while PH increased as CP_BC and HID increased. However, the FLT of the papilla base did not appear to affect papilla fill or PH. From an esthetic perspective, CP_BC as well as HID should be considered as factors influencing the topography of interdental papilla.

Comparison of initial implant stability measured by Resonance Frequency Analysis between different implant systems / 대한치주과학회지

PURPOSE: The objective of this study was to compare initial implant stability measured by RFA between different implant systems during the initial healing period. MATERIAL AND METHODS: Fifty-four patients (36 males/18 females) who had been treated at the Department of Periodontology, Chonbuk National University Dental Hospital during the period between January and November in 2007 were included in the study. The mean age of the subjects was 49 years old (18 to 77). A total of 104 implants (Type A: 3i Osseotite(R) , Type B: Replace(R) select, Type C: ITI implant) were placed following the manufacturer's standard surgical protocols. Implant stability quotient (ISQ) readings were obtained for each implant at the time of surgery, 2-, and 4-month postoperatively. RESULT: No implant was failed during the observation period. At the baseline, the difference between mean ISQ values of 3 implant systems was statistically significant (p<0.05). However, at 2-, and 4-month following implant surgery, no significant difference was observed between ISQ values of the implant systems. In the same implant, the ISQ values of Type B and C implants increased (p<0.05), but those of Type A implants decreased during the 2-month healing period. The mean ISQ values of Type B and C implants showed a increasing tendency, while those of Type A implants were stable for the 4-month follow-up period. CONCLUSION: Within limits of this study, it can be concluded that implant design and surface topography of implant might influence the ISQ value and changing pattern during the initial healing period.

A systematic review of the complications of single implant-supported restorations / 대한치주과학회지

The aim of this study was to systematically investigate the complications of single implant-supported restorations followed more than 5-year. Thirty-five studies were selected for the systematic review. A total of 3932 single implants were included at the beginning of studies. Thirty-one implants were removed before loading and 91 implants after loading. The overall implant loss rate was 3.1 %. Implant losses were concentrated on the period between loading and 2-year follow-up, and, after a stable period, increased after 5-year follow-up. The mean marginal bone loss at single-tooth implants was well within 0.2 mm/year, i.e., acceptable annual bone loss by the implant success criteria. However, considerable amounts of single implants suffered a marginal bone loss at implant more than 0.2 mm/year. Fistula was a frequent biological complication in the early studies. The most frequent technical problem was a screw loosening, but its frequency was reduced after the use of a gold screw and torque controller. Within the limits of this study, the complications of single implants might be underestimated due to the lack of information about the biological and technical complications available in the relevant literature.

Influence of soft tissue and bone thickness on the dimensional change of peri-implant soft tissues: A clinical follow-up study / 대한치주과학회지

The aim of this study was to investigate the influence of peri-implant soft tissue and bone thickness on the early dimensional change of peri-implant soft tissue. Seventy-seven non-submerged implants of 39 patients which had been loaded more than 6 months were selected for the study. Following clinical parameters were measured; bucco-lingual bone width of the alveolar bone for implant placement before implant surgery; distance between implant shoulder and the first bone/implant contact at the surgery; presence of plaque, probing depth, bleeding on probing, width of keratinized mucosa, mucosa thickness, distance between implant shoulder and peri-implant mucosa, crown margin location at follow-up examination. The results showed that distance between implant shoulder and peri-implant mucosa (DIM) was correlated with probing depth and width of keratinized mucosa (p < 0.05). In addition, mucosa thickness was also correlated with probing depth (p<0.05). However, the bone width of alveolar bone and soft tissue thickness were not found to be correlated with DIM. It is important to understand the meaning of peri-implant tissue dimension in relation to dimensional changes of peri-implant soft tissue which designates appearance of implant-supported restorations. Future study is needed to elucidate the significance of the buccal bone thickness and soft tissue thickness with respect to the change of peri-implant soft tissue margin with the use of an instrument capable of measuring buccal bone thickness directly.