Literature review: Peri-implant disease

Aug. 13, 2013
Surgical-Restorative Resource™ Co-Editor Chris Salierno, DDS, cites key literature references as he focuses on the subject of peri-implant disease, which can be divided into peri-implant mucositis and peri-implantitis.
Peri-implant disease can be divided into peri-implant mucositis and peri-implantitis. Peri-implant mucositis is noted by the presence of bleeding, pain, or suppuration. Peri-implantitis may present the same way but is marked by the observation of radiographic bone loss beyond anticipated levels. The prevalence of peri-implant disease has been cited as high as 80% for peri-implant mucositis and between 28% and 56% for peri-implantitis (Lindhe et al, Ziztmann et al). It is caused by the bacteria in plaque and calculus similar to periodontal diseases around natural teeth (Luterbacher et al). Although the disease is caused by bacteria, there are other important risk factors for peri-implant disease, most notably tobacco use (Karbach et al). One way to reduce the incidence of the disease is to have a minimum of 2 mm of keratinized tissue around the implant to reduce plaque accumulation (Schrott et al). Once peri-implant mucositis has developed, there are nonsurgical treatment methods available, including mechanical debridement, antimicrobial rinse, and local or systemic antibiotics (Renvert et al). There is no consensus in the literature about the surgical treatment of peri-implantitis; however, some studies are showing promise (Froum et al).

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Luterbacher S, Mayfield L, Bragger U, Lang NP. Diagnostic characteristics of clinical and microbiological tests for monitoring periodontal and peri-implant mucosal tissue conditions during supportive periodontal therapy (SPT). Clin Oral Implants Res 2000; 10:521-529.

Ziztmann NU, Berglundh T. Definition and prevalence of peri-implant diseases. J Clin Periodontol 2008; 35(8 Suppl): 286-291.

Lindhe J, Meyle J. Peri-implant diseases: Consensus report of the sixth European workshop on periodontology. J Clin Periodontol 2008; 35(8 Suppl ): 282-285.

Renvert S, Roos-Jansaker AM, Claffey N. Nonsurgical treatment of peri-implant mucositis and peri-implantitis: a literature review. J Clin Periodontol 2008; 35(8 Suppl):305-315.

Karbach J, Callaway A, Kwon YD, d’Hoedt B, Al-Nawas B. Comparison of five parameters as risk factors for peri-mucositis. Int J Oral Maxillofac Implants 2009; 24:491-496.

Schrott AR, Jiminez M, Hwang JW, Fiorellini J, Weber HP. Five-year evaluation of the influence of keratinized mucosa on peri-implant soft-tissue health and stability around implants supporting full-arch mandibular fixed prostheses. Clin Oral Implants Res 2009;20:1170-1177.

Froum SJ, Froum SH, Rosen PS. Successful management of peri-implantitis with a regenerative approach: a consecutive series of 51 treated implants with 3- to 7.5-year follow up. Int J Periodontics Restorative Dent 2012;32(1):11-20.