Dental News - Systematic overview improves understanding of periimplantitis

Dental Tribune International

Thu. 28. June 2018

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PHILADELPHIA, U.S.: Implant-retained prostheses are now a preferable substitute to conventional dentures because they are more comfortable, stable and functional. Despite these advantages, dental implants can create problems for patients, including the serious inflammatory condition of periimplantitis, which can cause extensive bone loss. A recent study conducted at Temple University in the U.S. examined current scientific literature to gain a better understanding of periimplantitis and help clinicians more quickly detect and treat the condition.

The researchers performed a database search for systematic reviews and meta-analyses on periimplantitis and included 33 scientific journal articles in their overview. They collected data from these papers to answer several questions, including what risk factors and microorganisms are associated with periimplantitis and the best diagnostics and treatment options available.

A higher occurrence of periimplantitis was found among implant patients who were smokers and who had periodontitis, uncontrolled diabetes and cardiovascular disease. The condition was also associated with higher levels of specific cytokines, a type of protein important for the immune system. Dental implants serve as a surface where microorganisms settle and grow. Several bacterial species and viruses such as the Epstein–Barr virus were prevalent in patients who had periimplantitis. These microorganisms can form biofilms and cause inflammation characteristic of periimplantitis.

Clinicians now have a concise list of factors that predispose patients with implants to periimplantitis, and they can closely monitor patients with these risk factors. The authors concluded that five years post-implantation, the risk of periimplantitis increases, but this issue can be alleviated by maintenance programs.

“It is important to realize that dental implants require the same care and maintenance as natural teeth, especially in patients with a high risk for periimplantitis,” said lead author Dr. Miriam Ting from the university’s Kornberg School of Dentistry.

The authors pointed out that some surgical and nonsurgical treatments, as well as combinations of the two, are effective treatments for periimplantitis. However, no standard treatment for periimplantitis exists, and the authors were not able to deduce the most effective treatment from the available articles. Furthermore, the current literature uses different definitions of periimplantitis, making it difficult for clinicians to properly diagnose and treat the condition. Future work is needed to standardize the definition of periimplantitis, and larger clinical experiments are needed to determine the most effective treatment.

The study, titled “Peri-implantitis: A comprehensive overview of systematic reviews,” was published in the June 2018 issue of the Journal of Oral Implantology.

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