ORAL IMPLANTOLOGY
A COMPREHENSIVE REVIEW OF THE LOCAL RISK-FACTORS ASSOCIATED WITH THE ETIOLOGY OF PERI-IMPLANT DISEASES
Mohammed Alshehri 1a *
1
Dental Department, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia a
DDS, PhD, Consultant in Cosmetic, Restorative and Implant Dentistry
Cite this article: Alshehri M. A comprehensive review of the local risk-factors associated with the etiology of peri-implant diseases. Stoma Edu J. 2016; 3( 2): 193-199.
Received: March 10, 2016 Accepted: August 31, 2016
Available online: September 15, 2016
ABSTRACT
Background: A variety of factors( local and systemic) have been associated with the etiology of periimplant diseases. Objective: The aim was to provide an overview of current literature regarding the local risk-factors associated with the etiology of peri-implant diseases. Data sources: Indexed databases were searched till June 2016 using different combinations of the following key words:“ bruxism”;“ oral biofilm”;“ peri-implant diseases”;“ peri-implantitis”,“ riskfactors” and“ smoking”. Study selection: Clinical studies assessing the local risk-factors associated with the etiology of periimplantitis were included. Letters to the Editor, case-reports, case-series, in-vitro studies, studies on animal models and commentaries were excluded. Data extraction: The pattern of the present comprehensive review was customized to primarily summarize the pertinent information. Data synthesis: Poor bone density and volume are associated with the etiology of peri-implant diseases. Excessive plaque accumulation and history of periodontitis are core etiological factors associated with peri-implant diseases. The relative risk for peri-implantitis was significantly higher in patients with a previous history of periodontitis compared to peri-implantitis patients without a history of periodontal disease. Periodontopathogens associated with periodontitis have also been isolated from peri-implant sulci of patients with peri-implantitis. Peri-implantitis is most often manifested in patients with bruxism and tobacco smoking habit. Other factors associated with the etiology of peri-implant diseases include presence of cement excess and operator’ s clinical experience. Bone quality and quantity, poor oral hygiene, smoking, bruxism, occlusal overloading, history of periodontitis and operator’ s experience are common local factors associated peri-implant diseases. Keywords: dental implant; osseointegration; bruxism; smoking; periodontitis.
1. Introduction Dental implants are an innovative replacement for traditional fixed and removable dental prosthesis such as bridges and dentures, respectively 1. Numerous studies 2-4 have reported implant success and survival rates of up to 100 %. Nevertheless, with the increasing number of patients receiving dental implants, the prevalence of peri-implant diseases has also increased 1, 5. Peri-implant diseases are categorized into two types namely, peri-implant mucositis and periimplantitis. Peri-implant mucositis is characterized by soft tissue inflammation around the implant without any signs of alveolar bone loss 6. The clinical signs of peri-implant mucositis include bleeding on probing( BOP) and / or suppuration, which are usually associated with probing depth( PD) of at least 4 millimeters( mm) with no evidence of radiographic loss of bone 7, 8. According to a consensus report from the 6th European Workshop on Periodontology, peri-implantitis is defined as the presence of inflammation of the peri-implant mucosa and concurrent loss of supporting alveolar bone 6. Mombelli et al. 9 described peri-implantitis as a site-specific inflammatory condition, which displays clinical and radiographic features that
* Corresponding author:
Dr. Mohammad Alshehri, DDS, PhD, Assistant Professor and Consultant, Dental Department, King Khalid University Hospital, King Saud University Riyadh, Saudi Arabia Tel: + 96655380333, Fax: + 966114672428, e-mail: dr _ mzs @ hotmail. com
193