Snauwaert K, Duyck J, van Steenberghe D, Quirynen M, Naert I Time dependent failure rate and marginal bone loss of implant supported prostheses: a 15-year follow-up study. Clin Oral Invest. 2000; 4:13-20
Buser D, Weber HP, Donath K, Fiorellini JP, Paquette DW, Williams RC Soft tissue reactions to non-submerged unloaded titanium implants in beagle dogs. J Periodont. 1992; 63:225-235
Weber HP, Buser D, Donath K, Fiorellini JP, Doppalapudi V, Paquette DW, Williams RC Comparison of healed tissues adjacent to submerged and non-submerged unloaded titanium dental implants. A histometric study in beagle dogs. Clin Oral Implants Res. 1996; 7:11-19
Cochran DL The scientific basis for and clinical experiences with Straumann implants including the ITI Dental Implant System: a consensus report. Clin Oral Implants Res. 2000; 11:33-58
Abrahamsson I, Berglundh T, Glantz PO, Lindhe J The mucosal attachment at different abutments. An experimental study in dogs. J Clin Periodont. 1998; 25:721-727
Marsh PD Dental plaque: biological significance of a biofilm and community life-style. J Clin Periodont. 2005; 32:7-15
Mombelli A, Lang NP The diagnosis and treatment of peri-implantitis. Periodontology 2000. 1998; 17:63-76
Renvert S, Roos-Jansåker AM, Claffey N Non-surgical treatment of peri-implant mucositis and peri-implantitis: a literature review. J Clin Periodont. 2008; 35:305-315
Jovanovic S The management of peri-implant breakdown around functioning osseointegrated dental implants. J Periodont. 1993; 64:1176-1183
Luterbacher S, Mayfield L, Brägger 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; 11:521-529
Lang NP, Berglundh T Peri-implant diseases: where are we now? Consensus of the Seventh European Workshop on Periodontology. J Clin Periodont. 2011; 38:178-181
Ericsson I, Berglundh T, Marinello C, Liljenberg B, Lindhe J Long-standing plaque and gingivitis at implants and teeth in the dog. Clin Oral Implants Res. 1992; 3:99-103
Berglundh T, Zitzmann NU, Donati M Are peri-implantitis lesions different from periodontitis lesions?. J Clin Periodont. 2011; 38:188-202
Klinge B, Hultin M, Berglundh T Peri-implantitis. Dent Clinic N Am. 2005; 49:661-676
Lindhe J, Berglundh T, Ericsson I, Liljenberg B, Marinello C Experimental breakdown of peri-implant and periodontal tissues. A study in the beagle dog. Clin Oral Implants Res. 1992; 3:9-16
Lindhe J, Meyle J Peri-implant diseases: Consensus Report of the Sixth European Workshop on Periodontology. J Clin Periodont. 2008; 35:282-285
Heitz-Mayfield LJ, Huynh-Ba G History of treated periodontitis and smoking as risks for implant therapy. Int J Oral Maxillofac Implants. 2009; 24:(Suppl)39-68
Renvert S, Persson GR Periodontitis as a potential risk factor for peri-implantitis. J Clin Periodont. 2009; 36:9-14
Dentino A, Lee S, Mailhot J, Hefti AF Principles of periodontology. Periodontolology 2000. 2013; 61:16-53
Quirynen M, Listgarten MA Distribution of bacterial morphotypes around natural teeth and titanium implants ad modum Brånemark. Clin Oral Implants Res. 1990; 1:8-12
Heydenrijk K, Meijer HJ, van der Reijden WA, Raghoebar GM, Vissink A, Stegenge B Microbiota around root-form endosseous implants: a review of the literature. Int J Oral Maxillofac Implants. 2002; 17:829-838
Hultin M, Gustafsson A, Hallström H, Johansson LA, Ekfeldt A, Klinge B Microbiological findings and host response in patients with peri-implantitis. Clin Oral Implants Res. 2002; 13:349-358
Eke PI, Braswell LD, Fritz ME Microbiota associated with experimental peri-implantitis and periodontitis in adult Macaca mulatta monkeys. J Periodont. 1998; 69:190-194
Mombelli A, Müller N, Cionca N The epidemiology of peri-implantitis. Clin Oral Implants Res. 2012; 23:67-76
Klinge B, Meyle J Peri-implant tissue destruction. The Third EAO Consensus Conference 2012. Clin Oral Implants Res. 2012; 23:108-110
Zittzman NU, Berglundh T Definition and prevalence of peri-implant diseases. J Clin Periodont. 2008; 35:286-291
Atieh MA, Alsabeeha NH, Faggion CM, Duncan WJ The frequency of peri-implant diseases: a systematic review and meta-analysis. J Periodont. 2012;
Roos-Jansåker AM Long-time follow up of implant therapy and treatment of peri-implantitis. Swed Dent J. 2007; 188:(Suppl)7-66
Lang NP, Berglundh T, Heitz-Mayfield LJ, Pjetursson BE, Salvi GE, Sanz M Consensus statements and recommended clinical procedures regarding implant survival and complications. Int J Oral Maxillofac Implants. 2004; 19:(Suppl)150-154
Mombelli A, Mühle T, Brägger U, Lang NP, Bürgin WB Comparison of periodontal and peri-implant probing by depth-force pattern analysis. Clin Oral Implants Res. 1997; 8:448-454
Gerber JA, Tan WC, Balmer TE, Salvi GE, Lang NP Bleeding on probing and pocket probing depth in relation to probing pressure and mucosal health around oral implants. Clin Oral Implants Res. 2009; 20:75-78
Garnick JJ, Silverstein L Periodontal probing: probe tip diameter. J Periodontol. 2000; 71:96-103
Claffey N, Polyzois I, Ziaka P An overview of nonsurgical and surgical therapy. Periodontology 2000. 2004; 36:35-44
Serino G, Turri A, Lang NP Probing at implants with peri-implantitis and its relation to clinical peri-implant bone loss. Clin Oral Implants Res. 2013; 24:91-95
Lang NP, Wetzel AC, Stich H, Caffesse RG Histologic probe penetration in healthy and inflamed peri-implant tissues. Clin Oral Implants Res. 1994; 5:191-201
Schou S, Holmstrup P, Stoltze K, Hjorting-Hansen E, Fiehn NE, Skovgaard LT Probing around implants and teeth with healthy or inflamed peri-implant mucosa/gingiva. A histologic comparison in cynomolgus monkeys (Macaca fascicularis). Clin Oral Implants Res. 2002; 13:113-126
Etter TH, Håkanson I, Lang NP, Trejo PM, Caffesse RG Healing after standardized clinical probing of the peri-implant soft tissue seal: a histomorphometric study in dogs. Clin Oral Implants Res. 2002; 13:571-580
Serino G, Turri A, Lang NP Probing at implants with peri-implantitis and its relation to clinical peri-implant bone loss. Clin Oral Implants Res. 2013b; 24:91-95
Christensen MM, Joss A, Lang NP Reproducibility of automated periodontal probing around teeth and osseointegrated oral implants. Clin Oral Implants Res. 1997; 8:455-464
Luterbacher S, Mayfield L, Brägger 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; 11:521-529
Haffajee AD, Socransky SS, Lindhe J, Kent RL, Okamoto H, Yoneyama T Clinical risk indicators for periodontal attachment loss. J Clin Periodont. 1991; 18:117-125
Jepsen S, Ruhling A, Jepsen K, Ohlenbusch B, Albers HK Progressive peri-implantitis. Incidence and prediction of peri-implant attachment loss. Clin Oral Implants Res. 1996; 7::133-142
Boynueğri D, Nemli SK, Kasko YA Significance of keratinized mucosa around dental implants: a prospective comparative study. Clin Oral Implants Res. 2013; 24:928-933
Bouri A, Bissada N, Al-Zahrani MS, Faddoul F, Nouneh I Width of keratinized gingiva and the health status of the supporting tissues around dental implants. Int J Oral Maxillofac Implants. 2008; 23:323-326
Chung DM, Oh TJ, Shotwell JL, Misch CE, Wang HL Significance of keratinized mucosa in maintenance of dental implants with different surfaces. J Periodontol. 2006; 77:1410-1420
Kim BS, Kim YK, Yun PY, Yi YJ, Lee HJ, Kim SG, Son JS Evaluation of peri-implant tissue response according to the presence of keratinized mucosa. Oral Surg Oral Med Oral Pathol Oral Radiol Endodont. 2009; 107:24-28
Atassi F Peri-implant probing: positives and negatives. Implant Dent. 2002; 11:356-362
Sewerin IP Errors in radiographic assessment of marginal bone height around osseointegrated implants. Scand J Dent Res. 1990; 98:428-433
Fransson CSweden: Department of Periodontology, Institute of Odontology Sahlgrenska, Academy University of Gothenburg; 2009
Schwartz F, Herten M, Sager M, Bieling K, Sculean A, Becker J Comparison of naturally occurring and ligature-induced peri-implantitis bone defects in humans and dogs. Clin Oral Implants Res. 2007; 18:161-170
Dörtbudak O, Haas R, Bernhart T, Mailath-Pokorny G Lethal photosensitization for decontamination of implant surfaces in the treatment of peri-implantitis. Clin Oral Implants Res. 2001; 12:104-108
Leonhard Å Five-year clinical, microbiological, and radiological outcome following treatment of peri-implantitis in man. J Periodont. 2003; 74:1415-1422
Máximo MB, de Mendonça AC, Renata Santos V, Figueiredo LC, Feres M, Duarte PM Short-term clinical and microbiological evaluations of peri-implant diseases before and after mechanical anti-infective therapies. Clin Oral Implants Res. 2009; 20:99-108
Renvert S, Polyzois I, Maguire R Re-osseointegration on previously contaminated surfaces: a systematic review. Clin Oral Implants Res. 2009; 20:216-227
Lee J-H, Kwon Y-H, Herr Y, Shin S-II, Chung J-H Effect of erbium-doped: yttrium, aluminium and garnet laser irradiation on the surface microstructure and roughness of sand-blasted, large grit, acid-etched implants. J Periodont Implant Sci. 2011; 41:135-142
Heitz-Mayfield LJ, Salvi GE, Mombelli A, Faddy M, Lang NP Anti-infective surgical therapy of peri-implantitis. A 12-month prospective clinical study. Clin Oral Implants Res. 2012; 23:205-210
Claffey N, Clarke E, Polzois I, Renvert S Surgical treatment of peri-implantitis. J Clin Periodont. 2008; 35:316-332
Porras R, Anderson GB, Caffesse R, Narendran S, Trejo PM Clinical response to 2 different therapeutic regimens to treat peri-implant mucositis. J Periodont. 2002; 73:1118-1125
Ji YJ, Tang ZH, Wang R, Cao J, Cao CF, Jin LJ Effect of glycine powder air-polishing as an adjunct in the treatment of peri-implant mucositis: a pilot clinical trial. Clin Oral Implants Res. 2014; 25:683-689
Karring ES, Stavropoulos A, Ellegaarg B, Karring T Treatment of peri-implantitis by the Vector system. Clin Oral Implants Res. 2005; 16:288-293
Schwartz F, Sculean A, Rothamel D, Schwenzer K, Georg T, Becker J Clinical evaluation of an Er:YAG laser for nonsurgical treatment of peri-implantitis: a pilot study. Clin Oral Implants Res. 2005; 16:44-52
Renvert S, Lessem J, Dahlén G, Lindahl C, Svensson M Topical minocycline microspheres versus topical chlorhexidine gel as an adjunct to mechanical debridement of incipient peri-implant infections: a randomized clinical trial. J Clin Periodont. 2006; 33:362-369
Kreisler M, Götz H, Duschner H Effect of Nd:YAG, Ho:YAG, Er:YAG, CO2, and GaAIAs laser irradiation on surface properties of endosseous dental implants. Int J Oral Maxillofac Implants. 2002; 17:202-211
Renvert S, Lessem J, Dahlén G, Renvert H, Lindahl C Mechanical and repeated antimicrobial therapy using a local drug delivery system in the treatment of peri-implantitis: a randomized clinical trial. J Periodont. 79:836-844
Rimondini L, Farè S, Brambilla E, Felloni A, Consonni C, Brossa F, Carrassi A The effect of surface roughness on early in vivo plaque colonization on titanium. J Periodont. 1997; 68:556-562
Thierbach R, Eger T Clinical outcome of a nonsurgical and surgical treatment protocol in different types of peri-implantitis: a case series. Quintessence Int. 2013; 44::137-148
Schou S, Berglundh T, Lang NP Surgical treatment of peri-implantitis. Int J Oral Maxillofac Implants. 2004; 19:140-149
Hayek RR, Araújo NS, Gioso MA, Ferreira J, Baptista-Sobrinho CA, Yamada AM, Ribeiro MS Comparative study between the effects of photodynamic therapy and conventional therapy on microbial reduction in ligature-induced peri-implantitis in dogs. J Periodont. 2005; 76:1275-1281
Serino G, Turri A Outcome of surgical treatment of peri-implantitis: results from a 2-year prospective clinical study in humans. Clin Oral Implants Res. 2011; 22:1214-1220
Romeo E, Lops D, Chiapasco M, Ghisolfi M, Vogel G Therapy of peri-implantitis with resective surgery. A 3-year clinical trial on rough screw-shaped oral implants. Part II: radiographic outcome. Clin Oral Implants Res. 2007; 18:179-187
Sharon E, Shapira L, Wilensky A, Abu-Hatoum R, Smidt A Efficiency and thermal changes during implantoplasty in relation to bur type. Clin Implant Dent Relat Res. 2013; 15:292-296
Hitti RA, Kerns DG Guided bone regeneration in the oral cavity: a review. Open Pathol J. 2011; 5:33-45
Nyman S, Lindhe J, Karring T, Rylander H New attachment following surgical treatment of human periodontal disease. J Clin Periodont. 1982; 9:290-296
Gottlow J, Nyman S, Lindhe J, Karring T, Wennstrom J New attachment formation in the human periodontium by guided tissue regeneration. Case reports. J Clin Periodont. 1986; 13:604-616
Dahlin C, Sennerby L, Lekholm U, Linde A, Nyman S Generation of new bone around titanium implants using a membrane technique: an experimental study in rabbits. Int J Oral Maxillofac Implants. 1989; 4:19-25
Jovanovic SA, Spiekermann H, Richter EJ Bone regeneration around titanium dental implants in dehisced defect sites: a clinical study. Int J Maxillofac Implants. 1992; 7:233-245
Zybutz MD, Laurell L, Rapoport DA, Persson GR Treatment of intrabony defects with resorbable materials, non-resorbable materials and flap debridement. J Clin Periodont. 2000; 27:169-178
Weltman R, Trejo PM, Morrison E, Caffesse R Assessment of guided tissue regeneration procedures in intrabony defects with bioabsorbable and non-resorbable barriers. J Periodont. 1997; 68:582-590
Khoury F, Buchmann R Surgical therapy of peri-implant disease: a 3-year follow-up study of cases treated with 3 different techniques of bone regeneration. J Periodont. 2001; 72:1498-1508
Wikesjö UM, Qahash M, Thomson RC, Cook AD, Rohrer MD, Wozney JM, Hardwick WR Space-providing expanded polytetrafluoroethylene devices define alveolar augmentation at dental implants induced by recombinant human bone morphogenetic protein 2 in an absorbable collagen sponge carrier. Clin Implant Dent Relat Res. 2003; 5:112-123
Nguyen-Hieu T, Borghetti A, Aboudharam G Peri-implantitis: from diagnosis to therapeutics. J Investig Clin Dent. 2012; 3:79-94
Hürzeler MB, Quiñones CR, Morrison EC, Caffesse RG Treatment of peri-implantitis using guided bone regeneration and bone grafts, alone or in combination, in beagle dogs. Part 1: Clinical findings and histologic observations. Int J Oral Maxillofac Implants. 1995; 10:474-484
Hürzeler MB, Quiñones CR, Schüpback P, Morrison EC, Caffesse RG Treatment of peri-implantitis using guided bone regeneration and bone grafts, alone or in combination, in beagle dogs. Part 2: Histologic findings. Int J Oral Maxillofac Implants. 1997; 12:168-175
Machado MA, Stefani CM, Sallum EA, Sallum AW, Tramontina VA, Nociti Júnior FH Treatment of ligature-induced peri-implantitis defects by regenerative procedures: a clinical study in dogs. J Oral Sci. 1999; 41:181-185
Schwartz F, Boeling K, Latz T, Nuesry E, Becker J Healing of intrabony peri-implantitis defects following application of a nanocrystalline hydroxyapatite (Ostim) or a bovine-derived xenograft (Bio-Oss) in combination with a collagen membrane (Bio-Gide). A case series. J Clin Periodont. 2006; 33:491-499
Schwarz F, Sculean A, Bieling K, Ferrari D, Rothamel D, Becker J Two-year clinical results following treatment of peri-implantitis lesions using a nanocrystalline hydroxyapatite or a natural bone mineral in combination with a collagen membrane. J Clin Periodont. 2008; 35:80-87
Renvert S, Polyzois I, Claffey N Surgical therapy for the control of peri-implantitis. Clin Oral Implants Res. 2012; 6:(Suppl)84-94
Oh TJ, Yoon J, Misch CE, Wang HL The causes of early implant bone loss: myth or science?. J Periodont. 2002; 73:322-333
Steigenga JT, Al-Shammari KF, Nociti FH, Misch CE, Wang HL Dental implant design and its relationship to long-term implant success. Implant Dent. 2003; 12:306-317
Adell R, Lekholm U, Rockler B, Brånemark PI, Lindhe J, Eriksson B, Sbordone L Marginal tissue reaction at osseointegrated titanium fixtures (1). A 3-year longitudinal prospective study. Int J Oral Maxillofac Surg. 1986; 15:39-52
The use of dental implants in replacing missing teeth is proven to be a valid treatment with a high success rate. To achieve the best treatment outcome in all implant systems, the implant has to be able to integrate with the surrounding tissue. However, dental implants are affected by peri-implant diseases and may fail as a result. As the number of implants placed continues to increase, the prevalence of peri-implant disease will also increase. This requires preventive measures to inhibit the development of the disease and stop its progression.
Clinical Relevance: Understanding how to maintain healthy peri-implant tissue as well as diagnosis and treatment of disease are vital for every dentist and dental student.
Article
Dental implants provide an alternative and a predictable treatment option for replacement of missing teeth with a high success rate.1,2 However, dental treatment using oral implants may fail as a result of biological complications such as peri-implant mucositis and peri-implantitis.1,2,3,4,5 When such complications occur and are not treated properly, this may lead to the loss of the affected implant. Thus, following implant placement, an effective check-up protocol and supportive therapy to maintain peri-implant tissue health is of paramount importance. This article provides an overview of peri-implant diseases, their diagnosis and treatments which are vital for every dental care professional.
Several studies have reported that the soft tissue that surrounds an implant has similar features to the soft tissue that surrounds teeth (Figure 1 and Table 1).2,3,4,5 Therefore, the peri-implant soft tissue consists of a junctional epithelium which is attached to the implant and/or abutment surface through a hemi-desmosomal attachment and a basal lamina. However, the basal lamina is less evident around an implant than teeth. Apical to the junctional epithelium and coronal to the crest of alveolar bone, there is an area of connective tissue which includes a dense circular avascular zone of fibres that are surrounded by a loose vascular connective tissue.5 Collagen fibres arising from the crest of alveolar bone are oriented parallel to the implant surface/abutment towards the oral epithelium. Unlike connective tissue that is attached to the root surface, connective tissue that is located close to implant surface is not attached to it. Horizontal fibres, originating from the periosteum and the alveolar crest to the oral epithelium, were also found. The junctional epithelium and connective tissue are collectively known as the biologic width. This biologic width is comparable to those found around teeth. The apical extension of the peri-implant epithelium may be varied according to the implant placement technique; submerged and non-submerged. A study in beagle dogs4 reported that the apical extension of the peri-implant junctional epithelium was significantly smaller and the attachment level significantly higher around non-submerged, one-stage implants than submerged implants with second-stage trans-mucosal abutments.4
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:
