Is bleeding on probing a differential diagnosis between periimplant health and disease?

ABSTRACT

As far as the periimplant anatomy is considered, the question raised is whether or not healthyperiimplant tissues present bleeding on probing (BOP). Aim: To assess if the criterion BOP isstrictly related to periimplant disease (PID). Methods: 134 patients were included in this study. Allperiimplant regions were clinically and radiographically evaluated. Patients were assigned to 3groups based on radiographic and clinical aspects in the periimplant region Group A (healthysites)- no signs of mucosal inflammation or bone loss; Group B (mucositis) - red and swollenmucosa, but no radiographic bone loss; Group C (periimplantitis) - radiographically confirmedpathological bone loss. After this classification, all periimplant sulci were probed at 4 sites (mesial,distal, buccal, lingual/palatal). Patients’ mean age was 51.7±12.4 years, 77 women and 57 men,with a total of 486 osseointegrated endosseous implants. Results: Groups A and C showedsignificant difference in age and implant region distribution (p=0.009 and p=0.008, respectively).After initial clinical and radiographic diagnosis of periimplant status, 33 (20.1%) regions showedBOP in group A. All regions in Group B presented BOP. In Group C, 41 (19.9%) regions showedno BOP. All groups differed significantly considering BOP as diagnosis parameter (p<0.0001).Conclusions: BOP was always present in inflamed mucosa, but it was not always absent inhealthy mucosa. Not all periimplantitis regions showed BOP. Clinical and radiographic aspectsmust always be considered together for diagnosis of PID, even if BOP is absent.