Peri-implant diseases: prevalence and risk factors

Abstract

Background: The use of osseointegrated implants as a basement for the prosthetic replacement of missing teeth has become whidespread in the last decade. Most of the studies indicate that the success of dental implants is 95–97% (Zarb et al., Lindsay et al.). Despite the high success rate, part of a functioning implants is being lost. What factors can lead implant loss? Aim: To describe the prevalence and risk factors of periimplant diseases including peri-implant mucositis and periimplantitis. Methods: A MEDLINE search (PubMed) was conducted and work published between December 1990 and December 2011 in English language was included in the review. Cross–sectional and longitudinal studies including 30 implant–treated subjects exhibiting a function time of 5 years were considered. The search resulted in 3645 articles. Thirty-eight studies full-filled the criteria and were included to the review. Results: Two cross-sectional studies report that peri-implant mucositis occurs in 72–93% of the implants inserted. The prevalence of peri-implantitis in three cross-sectional and four perspective studies was reported to be 1–27.4% of the implants. Five controlled clinical trials showed that eriodontitis patients are 2.6–5 times more prone to have peri-implant disease as compared with non-periodontitis patients. Very bad oral hygiene was highly associated with peri-implantitis with an OR = 14.3; CI (2.0–4.1); 95%. For patients with poor oral hygiene, the amount bone loss smokers had nearly three times more as compared with non-smokers. Eleven studies report on the frequency of peri-implant disease in smokers and nonsmokers. The results show that smokers are at higher risk to develope peri-implant disease. Cement remnants in the sulcus of the implant in 84% of the cases causes periimplantitis. Conclusions and clinical implications: Studies, providing data on prevalence of peri-implant diseases, report different results: perspective studies show higher prevalence (27.4%) of periimplantitis among the implants that are in function for about 5 years while cross-sectional studies show that the longer (>10 years) implants are in a function, the higher probability of periimplantitis (24.8%) and periimplant mucositis (93%) is. The review identified strong evidence that poor oral hygiene, a history of periodontitis and cigatette smoking are risk factors for peri-implant diseases. Future prospective studies are required to confirm that genetic polymorphism, alcohol consumption and diabetes are true risk factors for periimplant diseases.