OBJECTIVES: The aim of the current review was to describe the prevalence of peri-implant diseases including peri-implant mucositis and peri-implantitis. MATERIAL AND METHODS: A MEDLINE search (PubMed) until December 2007 was conducted and different keywords related to the prevalence of peri-implant diseases were used. Cross-sectional and longitudinal studies including < or =50 implant-treated subjects exhibiting a function time of < or =5 years were considered. RESULTS AND CONCLUSION: The current review revealed that only a few studies provided data on the prevalence of peri-implant diseases. Cross-sectional studies on implant-treated subjects are rare and data from only two study samples were available. Peri-implant mucositis occurred in approximately 80% of the subjects and in 50% of the implants. Peri-implantitis was found in 28% and < or =56% of subjects and in 12% and 43% of implant sites.

Definition and prevalence of peri-implant diseases.

Objective: To systematically review the incidence of biological and technical complications in implant therapy reported in prospective longitudinal studies of at least 5 years.

Methods:  A MEDLINE search was conducted for prospective longitudinal studies with follow-up periods of at least 5 years. Screening and data abstraction were performed independently by multiple reviewers. The types of complications assessed were as follows: implant loss, sensory disturbance, soft tissue complications, peri-implantitis, bone loss ≥2.5 mm, implant fracture and technical complications related to implant components and suprastructures.

Results:  The search provided 1310 titles and abstracts, out of which 159 were selected for full-text analysis. Finally, 51 studies were included. Meta analysis of these studies indicated that implant loss prior to functional loading is to be expected to occur in about 2.5% of all implants placed in implant therapy including more than one implant and when routine procedures are used. Implant loss during function occurs in about 2–3% of implants supporting fixed reconstructions, while in overdenture therapy >5% of the implants can be expected to be lost during a 5-year period. Few studies (41% of those included) reported data on the incidence of persisting sensory disturbance >1 year following implant surgery. Most of the studies that provided such data reported on the absence or a low incidence (1–2%) of this complication beyond this interval. A higher incidence of soft tissue complications was reported for patients treated with implants supporting overdentures. There is limited information regarding the occurrence of peri-implantitis and implants exhibiting bone loss ≥2.5 mm. Implant fracture is a rare complication and occurs in <1% of all implants during a 5-year period. The incidence of technical complications related to implant components and suprastructures was higher in overdentures than in fixed reconstructions.

Conclusion:  Implant loss was most frequently described (reported in about 100% of studies), while biological complications were considered in only 40–60% and technical complications in only 60–80% of the studies. This observation indicates that data on the incidence of biological and technical complications may be underestimated and should be interpreted with caution.

A systematic review of the incidence of biological and technical complications in implant dentistry reported in prospective longitudinal studies of at least 5 years

Background:Grafting the floor of the maxillary sinus has become the most common surgical intervention for increasing alveolar bone height prior to the placement of endosseous dental implants in the posterior maxilla. Outcomes of this procedure may be affected by specific surgical techniques, simultaneous versus delayed implant placement, use of barrier membranes over the lateral window, selection of graft material, and the surface characteristics and the length and width of the implants. Rationale:The primary objective of this systematic review was to determine the efficacy of the sinus augmentation procedure and compare the results achieved with various surgical techniques, grafting materials, and implants. Focused Question: In patients requiring dental implant placement, what is the effect on implant survival of maxillary sinus augmentation versus implant placement in the non-grafted posterior maxilla? Search Protocol: MEDLINE, the Cochrane Oral Health Group Specialized Trials Register, and the Database...

/pdf/effect-of-maxillary-sinus-augmentation-on-the-survival-of-4uoigk3y04.pdf

Effect of Maxillary Sinus Augmentation on the Survival of Endosseous Dental Implants. A Systematic Review

Background
To develop preventive strategies addressing peri-implant diseases, a thorough understanding of the epidemiology is required

Aim
The aim was to systematically assess the scientific literature in order to evaluate the prevalence, extent and severity of peri-implant diseases

Material & Methods
Data were extracted from identified studies Meta-analyses for prevalence of peri-implant mucositis and peri-implantitis were performed The effect of function time and disease definition on the prevalence of peri-implantitis was evaluated by meta-regression analyses Data on extent and severity of peri-implant diseases were estimated if not directly reported

Results
Fifteen articles describing 11 studies were included Case definitions for mucositis and peri-implantitis varied The prevalence of peri-implant mucositis and peri-implantitis ranged from 19 to 65% and from 1 to 47%, respectively Meta-analyses estimated weighted mean prevalences of peri-implant mucositis and peri-implantitis of 43% (CI: 32–54%) and 22% (CI: 14–30%), respectively The meta-regression showed a positive relationship between prevalence of peri-implantitis and function time and a negative relationship between prevalence of peri-implantitis and threshold for bone loss Extent and severity of peri-implant diseases were rarely reported

Conclusion
Future studies on the epidemiology of peri-implant diseases should consider (i) applying consistent case definitions and (ii) assessing random patient samples of adequate size and function time

https://www.onlinelibrary.wiley.com/doi/epdf/10.1111/jcpe.12334

Peri‐implant health and disease. A systematic review of current epidemiology

The present study was done to determine the long-term success and survival of fixed partial dentures (FPDs) and to evaluate the risks for failures due to specific biological and technical complications. A MEDLINE search (PubMed) from 1966 up to March 2004 was conducted, as well as hand searching of bibliographies from relevant articles. Nineteen studies from an initial yield of 3658 titles were finally selected and data were extracted independently by three reviewers. Prospective and retrospective cohort studies with a mean follow-up time of at least 5 years in which patients had been examined clinically at the follow-up visits were included in the meta-analysis. Publications only based on patients records, questionnaires or interviews were excluded. Survival of the FPDs was analyzed according to in situ and intact failure risks. Specific biological and technical complications such as caries, loss of vitality and periodontal disease recurrence as well as loss of retention, loss of vitality, tooth and material fractures were also analyzed. The 10-year probability of survival for fixed partial dentures was 89.1% (95% confidence interval (CI): 81-93.8%) while the probability of success was 71.1% (95% CI: 47.7-85.2%). The 10-year risk for caries and periodontitis leading to FPD loss was 2.6% and 0.7%, respectively. The 10-year risk for loss of retention was 6.4%, for abutment fracture 2.1% and for material fractures 3.2%.

A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years

In the present multi-center study. non-submerged ITI implants were prospectively followed to evaluate their long-term prognosis in fully and partially edentulous patients. In a total of 1003 patients, 2359 implants were consecutively inserted. Following a healing period of 3–6 months, the successfully integrated implants were restored with 393 removable and 758 fixed restorations. Subsequently, all consecutive implants were documented annually up to 8 years. At each examination, the clinical status of all implants was evaluated according to predefined criteria of success. Therefore, the data base allowed the evaluation of 8-year cumulative survival and success rates for 2359 implants. In addition, cumulative success rates were calculated for implant subgroups divided per implant type, implant length. and implant location. Furthermore, the actual 5-year survival and success rates could be determined for 488 implants. During the healing period, 13 implants did not successfully integrate, whereas 2346 implants fulfilled the predefined criteria of success. This corresponds with an early failure rate of 0.55%. During follow-up, 19 implants were classified as failures due to several reasons. In addition, 17 implants (= 0.8%) demonstrated at the last annual examination a suppurative periimplant infection. Including 127 drop out implants (= 5.4% drop out rate) into the calculation, the 8-year cumulative survival and success rates resulted in 96.7% and 93.3%, respectively. The analysis of implant subgroups showed slightly more favorable cumulative success rates for screw type implants (> 95%) compared to hollow-cylinder implants (91.3%). and clearly better success rates for mandibular implants (= 95%) when compared to maxillary implants (= 87%). The actual 5-year survival and success rates of 488 implants with 98.2% and 97.3%. respectively, were slightly better than the estimated 5-year cumulative survival and success rates of 2359 implants indicating that the applied life table analysis is a reliable statistical method to evaluate the long-term prognosis of dental implants. It can be concluded that non-submerged ITI implants maintain success rates well above 90% in different clinical centers for observation periods up to 8 years.

Long-term evaluation of non-submerged ITI implants. Part 1: 8-year life table analysis of a prospective multi-center study with 2359 implants.

Objectives
The aim of the present investigation was the analysis of the factors presumptively affecting the accuracy outcome of cone-beam computed tomography (CBCT)-derived laboratory-based surgical guides for implant placement in partially edentulous patients.

Materials and methods
In 52 partially edentulous patients a total of 132 implants were placed following CBCT diagnostics with the aid of laboratory-fabricated, tooth-borne templates. Based on the image fusion technique measurements were done to calculate linear and angular deviations between virtually planned and placed implants. The implant sites were stratified according to four factors that presumably may influence the transfer accuracy: (i) type of arch (maxilla/mandible), (ii) kind of template (single-tooth gap/interrupted dental arch/shortened dental arch/reduced residual dentition), (iii) surgical technique (flapless/open flap), (iv) number of sleeve-guided site preparation steps (fully guided placement/freehand placement/freehand final drilling). The data were analyzed using analysis of variance and the Bonferroni test.

Results
The transfer accuracy of shoulder level, apex level, and angulation was similar for maxilla and mandible as well as for flapless and open flap approach. The differences were small in magnitude and reached no or only a borderline statistical significance. At implant sites in the reduced residual dentition group, the discrepancies were more pronounced than in the single-tooth gap group, whereas no significant differences could be determined between free ending templates in the shortened dental arch and bilateral anchored templates in the interrupted dental arch. Implant placement through the guide allowed a more accurate implementation of the virtual plan to the surgical site than freehand insertion or freehand final drilling.

Conclusion
CBCT-derived laboratory-based surgical templates enabled an implant placement in the cancellous maxilla as well as flapless procedures without compromising the transfer accuracy. The number and distribution of the remaining teeth as well as the number of sleeve-guided implant site preparation steps influenced the extent of deviation that can be achieved in partial edentulism.

Factors influencing transfer accuracy of cone beam CT‐derived template‐based implant placement

A total of 114 ITI solid-screw implants was consecutively placed in 55 partially edentulous patients and restored with 68 fixed prostheses. The patients were followed for at least 5 years in a prospective study that focused on implant success and longitudinal reactions of the peri-implant hard and soft tissues. During the study period, 5 implants failed and 15 implants were lost to follow-up, resulting in a cumulative survival rate of 95.3% after 5 years of loading. The success analysis included additional strictly defined events ("first occurrence of marginal bone loss > or = 4 mm," "first occurrence of pocket depth > or = 4 mm," and "first occurrence of crevicular fluid volume > or = 2.5 mm") and resulted in a cumulative 5-year success rate of 89.0%. Median loss of marginal bone, as observed on radiographs, was 0.7 mm between implant placement and prosthetic treatment and 0.5 mm between prosthesis placement and the 5-year evaluation. Compared to the previous year's value, the annual increase in marginal bone loss did not reach a level of statistical significance between 1 and 5 years of function, so that a steady state prevailed. The incidence of lingual-palatal surfaces affected with remarkable plaque deposits increased from 13% after prosthesis placement to 23% after 5 years. Sulcus Bleeding index, probing depth, attachment level, and crevicular fluid volume were used to describe the health of the peri-implant soft tissues. The research parameters remained almost unchanged and indicated a soft tissue response within physiologic levels. Most mechanical complications were experienced during the first year of loading and were related to loosening of occlusal screws, which occurred in 8 (12%) of 68 restorations.

The longitudinal clinical effectiveness of ITI solid-screw implants in partially edentulous patients: a 5-year follow-up report.

Between November 1988 and July 1992, a total of 320 ITI screw implants were consecutively placed in 109 patients. The patients were observed in a prospective longitudinal study focusing on implant success and clinical proof. Radiologic and clinical parameters were established at specific time intervals to examine hard and soft tissue reactions. Clinical parameters and the measured bone resorption were analyzed for possible correlation. Seventy-five percent (n = 82) of patients were edentulous, and 16% (n = 17) had distal extensions or extended edentulous spaces. Nine percent (n = 10) of the implants were for single-tooth replacement. During the follow-up period, a total of 10 patients with 29 implants dropped out, and 6 implants were lost as a result of failed osseointegration. The cumulative implant survival rate was 98.1%, and the cumulative implant success rate, using strict criteria for success, was 97.1% after 3 years. The mean bone loss between implant placement and prosthetic restoration was 0.8 mm. For the period between prosthetic treatment and the 3-year examination, a mean annual bone resorption of approximately 0.1 mm was observed. The periodontal parameters indicated a healthy soft tissue response during the time of observation. The statistical correlation analysis showed a definite relationship between the crevicular fluid volume and bone resorption. The results of this 3-year study indicate that ITI screw implants, with their nonsubmerged healing characteristic, can serve as a reliable foundation for implant-supported restorations.

Hard and soft tissue reactions to ITI screw implants: 3-year longitudinal results of a prospective study.

Purpose The aim of this longitudinal study was to gain 5-year clinical documentation of the 1-stage surgical technique in connection with ITI solid-screw implants used in the edentulous mandible. Materials and methods One hundred patients with totally edentulous mandibles were treated with bar-retained overdentures supported by a total of 340 consecutively placed ITI solid-screw implants. The patients were followed at annual intervals for at least 5 years to evaluate implant success, longitudinal reactions of the peri-implant hard and soft tissues, and incidences of biologic and mechanical complications. Results During the trial period, a total of 4 implants failed, all prior to loading, and 51 implants were lost to follow-up, resulting in a cumulative survival rate of 98.8% after 5 years of functional service. The success analysis included additional strictly defined events (either "first occurrence of marginal bone loss > or = 4 mm" or "first occurrence of pocket depth > or = 4 mm" and "first occurrence of crevicular fluid flow rate > or = 2.5 mm) and resulted in a cumulative 5-year success rate of 95.7%. The median marginal bone loss experienced between implant placement and prosthetic treatment was 0.5 mm, followed by an annual bone level change of 0.1 mm for the functional period of 5 years. The increasing incidence of remarkable plaque deposits from 19% to 50% represented the difficulties of the patients in maintaining a high level of oral hygiene, particularly for the lingual surfaces. Sulcus Bleeding Index, probing depth, attachment level, and crevicular fluid flow rate were used to describe the health of the peri-implant soft tissues and remained almost within acceptable standards. Discussion Survival and success rates of implants, amount of marginal bone loss, and periodontal indices of peri-implant soft tissues were consistent with those reported in the literature regarding implants with the submerged healing concept. Conclusion With a cumulative survival rate of 98.8%, a cumulative success rate of 95.7%, and a median marginal bone loss of 0.5 mm during the healing period, followed by an annual rate of 0.1 mm after loading, non-submerged ITI solid-screw implants confirm the good clinical outcome of implant-supported treatment concepts for the rehabilitation of totally edentulous patients in a medium-term perspective.

Alexandra Behneke

Papers

Long-term evaluation of non-submerged ITI implants. Part 1: 8-year life table analysis of a prospective multi-center study with 2359 implants.

Factors influencing transfer accuracy of cone beam CT‐derived template‐based implant placement

The longitudinal clinical effectiveness of ITI solid-screw implants in partially edentulous patients: a 5-year follow-up report.

Hard and soft tissue reactions to ITI screw implants: 3-year longitudinal results of a prospective study.

A 5-year longitudinal study of the clinical effectiveness of ITI solid-screw implants in the treatment of mandibular edentulism.