Diagnosis, etiology, prevention and treatment in retrograde peri-implantitis / 中华口腔医学杂志

Retrograde peri-implantitis (RPI), a kind of rare biological complication in implant-supported prosthetic rehabilitation, has been reported more frequently in recent years. RPI is defined as the periapical lesion that occurs following implant placement while the coronal part of the implant achieves normal osseointegration. Due to the possibilities of asymptomatic clinical scenarios, RPI can easily be ignored if routine radiographic examination is absent postoperatively, which may postpone treatment and affect long-term outcome. The common cause is infection originating from the periapical lesion of the neighboring teeth, the residual bacteria at the implant site, the contaminated implant apex and etc. Treatment methods rely on the infection source and severity of defect. This article discusses the diagnosis, classification, etiology, and pathology as well as prevention and treatment of RPI in order to provide evidence for clinical decisions in the future.

Implant-based factor as possible risk for peri-implantitis

Abstract Peri-implantitis is currently a topic of major interest in implantology. Considered one of the main reasons of late implant failure, there is an emerged concern whether implant characteristics could trigger inflammatory lesion and loss of supporting bone. The purpose of this narrative review is to provide an evidence based overview on the influence of implant-based factors in the occurrence of peri-implantitis. A literature review was conducted addressing the following topics: implant surface topography; implant location; occlusal overload; time in function; prosthesis-associated factors (rehabilitation extension, excess of cement and implant-abutment connection); and metal particle release. Although existing data suggests that some implant-based factors may increase the risk of peri-implantitis, the evidence is still limited to consider them a true risk factor for peri-implantitis. In conclusion, further evidences are required to a better understanding of the influence of implant-based factors in the occurrence of peri-implantitis. Large population-based studies including concomitant analyses of implant- and patient-based factors are required to provide strong evidence of a possible association with peri-implantitis in a higher probability. The identification of these factors is essential for the establishment of strategies to prevent peri-implantitis.

The impact of maintenance on peri-implant health

Abstract Most of the literature evaluating dental implants focuses on implant survival, which is a limited proxy for the successful rehabilitation of patients with missing teeth. Success should include not only survival but also lack of mechanical, biological, and esthetics problems. A comprehensive review of local and systemic risk factors prior to implant placement will allow the tailoring of treatment planning and maintenance protocols to the patient's profile in order to achieve longitudinal success of the therapy. This review discusses the role of controlling different risk factors and prevention/treatment of peri-implant mucositis in order to avoid peri-implantitis. Although the literature addressing the topic is still scarce, the existing evidence shows that performing optimal plaque control and regular visits to the dentist seem to be adequate to prevent peri-implant lesions. Due to impossibility of defining a probing depth associate with peri-implant health, radiographic evaluations may be considered in the daily practice. So far, there is a strong evidence linking a past history of periodontal disease to peri-implant lesions, but this is not so evident for other factors including smoking and diabetes. The prevention of biological complications starts even before implant placement and include a broader analysis of the patient risk profile and tailoring the rehabilitation and maintenance protocols accordingly. It should be highlighted that the installation of implants does not modify the patient profile, since it does not modify genetics, microbiology or behavioral habits of any individual.

Factores e indicadores de riesgo de la periimplantitis como clave para su prevención / Factors and indicators of risk of periimplantitis as a key to its prevention

La rehabilitación con implantes dentales es un tratamiento ya común en estos tiempos. Este tratamiento es considerado costoso, y requiere también de inversión de tiempo de parte del paciente/odontólogo tratante. Si el paciente presenta las condiciones ideales, el tiempo requerido desde la colocación del implante hasta su rehabilitación puede variar entre 2 a 6 meses; pudiendo este tiempo prolongarse, si el paciente requiere procedimientos quirúrgicos previos o conjuntamente a la colocación del implante. A pesar de la creciente aceptación y éxito de la rehabilitación con implantes dentales, se han reportado diversas complicaciones. Entre estas, la periimplantitis es cada vez mas frecuente, y a pesar de eso, es una enfermedad para la cual aún no se ha encontrado una cura 100% efectiva, conllevando muchas veces a la pérdida del implante dental. La periimplantitis es una enfermedad con una prevalencia, según la literatura, de 10% en implantes y 20% en pacientes, y que se espera aumente su ocurrencia a la par como va aumentando la frecuencia de las rehabilitaciones con implantes dentales. No se ha encontrado aún una causa específica para esta enfermedad, por lo que se han definido según varios estudios factores e indicadores de riesgo con la finalidad de prevenirla y tratarla tempranamente. Es por eso que esta revisión de literatura busca informar sobre cuáles son los factores e indicadores de riesgo conocidos actualmente para la periimplantitis. (AU)

Nowadays rehabilitation with dental implants is a common treatment. This treatment is considered expensive, and also requires investment of time from the patient / dentist. If the patient presents ideal conditions, the required treatment time can vary between 2 to 6 months. This time may be extended if the patient requires prior procedures before or with the implant placement. Many complications have been reported with dental implants rehabilitation. Between these, Periimplantitis has increase its appeareance in the last years. However, a cure 100% effective for this has not be found yet and therefore, often leads to the loss of the dental implant.The periimplantitis is a disease with a prevalence according to the literature up to 20% among patients with dental implants and is expected to increase its occurrence. The specific cause of this disease has not be yet defined. That is the reason why several risk factors and risk indicators has been studied in order to prevent it and treat it early. This literature review aims to show what factors and risk indicators are currently known for periimplantitis. (AU)

Implant crest module: A review of biomechanical considerations.

The success of dental implants has long been established through various studies with a particular emphasis laid on an implant design. Crest module is that portion of a two-piece metal dental implant, designed to hold the prosthetic components in place and to create a transition zone to the load bearing implant body. Its design, position in relation to the alveolar crest, and an abutment implant interface makes us believe that, it has a major role in integration to both hard and soft tissues. Unfortunately, in most clinical conditions, early tissue breakdown leading to soft tissue and hard tissue loss begins at this region. Early crestal bone loss is usually highest during the first year after placement ranging from 0.9 to 1.6mm and averaged 0.05-0.13mm in the subsequent years . Various hypotheses have been stated to reason it however, none has been proved convincingly. In light of this, various attempts have been made to overcome this undesirable bone loss, by varying an implant design, the position, surgical protocol, and the prosthetic options. Irrespective of an implant system and designs that are used, crestal bone loss of up to the first thread is often observed. The purpose of this review is to look into the various designs and treatment modalities, which have been introduced into the crest module of an implant body to achieve the best biomechanical and esthetic result.