Original Article
Long-term analysis of osseointegrated implants in non-smoker patients with a previous history of periodontitis
Joerg Meyle,
Gero Gersok, Rolf-Hasso Boedeker,
José Roberto Gonzales,
Corresponding Author
Joerg Meyle
Department of Periodontology, Dental School Justus-Liebig-University of Giessen, Giessen, Germany
Address:
Dr. Joerg Meyle
Department of Periodontology
Justus-Liebig-University of Giessen
Germany
Schlangenzahl 14
35392 Giessen
Germany
E-mail: [email protected]
Search for more papers by this authorRolf-Hasso Boedeker
Institute of Medical Statistics, Faculty of Medicine Justus-Liebig-University of Giessen, Giessen, Germany
Search for more papers by this authorJosé Roberto Gonzales
Department of Periodontology, Dental School Justus-Liebig-University of Giessen, Giessen, Germany
Search for more papers by this authorJoerg Meyle,
Gero Gersok, Rolf-Hasso Boedeker,
José Roberto Gonzales,
Corresponding Author
Joerg Meyle
Department of Periodontology, Dental School Justus-Liebig-University of Giessen, Giessen, Germany
Address:
Dr. Joerg Meyle
Department of Periodontology
Justus-Liebig-University of Giessen
Germany
Schlangenzahl 14
35392 Giessen
Germany
E-mail: [email protected]
Search for more papers by this authorRolf-Hasso Boedeker
Institute of Medical Statistics, Faculty of Medicine Justus-Liebig-University of Giessen, Giessen, Germany
Search for more papers by this authorJosé Roberto Gonzales
Department of Periodontology, Dental School Justus-Liebig-University of Giessen, Giessen, Germany
Search for more papers by this authorConflict of interest and source of funding statement
The authors declare that they have no conflicts of interest. No external funding, apart from the support of the authors' institution, was available for this study. The authors declare that there are no conflicts of interest in this study.
Abstract
Aim
To evaluate long-term clinical and radiographic parameters of osseointegrated implants in non-smoker patients with a previous history of chronic periodontitis.
Materials and Methods
Fifty-four screw-type implants with a moderately roughened surface and internal hexagonal implant–abutment connection were placed according to a two-phase protocol and 40 reference teeth were analysed at baseline, and after 5 and 10 years. Pocket probing depth (PPD), clinical attachment level (CAL) and bleeding on probing were analysed 6x/tooth in all teeth, implants and reference teeth. Radiographic peri-implant bone level was measured on the mesial and distal surfaces. The prevalence of peri-implantitis and the survival rate of the implants were assessed at the patient and implant levels. Data were analysed using descriptive statistics, Mann–Whitney U-test, and Wald Z-test, at α = 5%.
Results
In implants, the CAL at 5 years was 0.3 mm higher, and at 10 years 1.2 mm higher in comparison to baseline. The corresponding data for the reference teeth were 0 mm and 0.5 mm respectively. Multilevel testing showed statistical difference for PPD between implants and teeth over time. After 10 years, the mean mesial bone loss was 0.63 ± 0.26 mm, and the mean distal bone loss was 0.56 ± 0.25. The survival rates were 100% and 92.3% for the implants in the mandible and the implants in the maxilla respectively.
Conclusions
Screw-type implants with internal hexagon placed in patients with a previous history of periodontitis attending a regular maintenance programme demonstrated stable clinical and radiographic results after 5 and 10 years.
References
- Adell, R., Lekholm, U., Rockler, B. & Branemark, P. I. (1981) A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. International Journal of Oral Surgery 10, 387–416.
- Aglietta, M., Siciliano, V. I., Rasperini, G., Cafiero, C., Lang, N. P. & Salvi, G. E. (2011) A 10-year retrospective analysis of marginal bone-level changes around implants in periodontally healthy and periodontally compromised tobacco smokers. Clinical Oral Implants Research 22, 47–53.
- Aglietta, M., Siciliano, V. I., Zwahlen, M., Bragger, U., Pjetursson, B. E., Lang, N. P. & Salvi, G. E. (2009) A systematic review of the survival and complication rates of implant supported fixed dental prostheses with cantilever extensions after an observation period of at least 5 years. Clinical Oral Implants Research 20, 441–451.
- Albrektsson, T. & Wennerberg, A. (2004a) Oral implant surfaces: Part 1–review focusing on topographic and chemical properties of different surfaces and in vivo responses to them. The International Journal of Prosthodontics 17, 536–543.
- Albrektsson, T. & Wennerberg, A. (2004b) Oral implant surfaces: Part 2–review focusing on clinical knowledge of different surfaces. The International Journal of Prosthodontics 17, 544–564.
- Aloufi, F., Bissada, N., Ficara, A., Faddoul, F. & Al-Zahrani, M. S. (2009) Clinical assessment of peri-implant tissues in patients with varying severity of chronic periodontitis. Clinical Implant Dentistry and Related Research 11, 37–40.
- Al-Zahrani, M. S. (2008) Implant therapy in aggressive periodontitis patients: a systematic review and clinical implications. Quintessence International 39, 211–215 Review.
- Arisan, V., Bolukbasi, N., Ersanli, S. & Ozdemir, T. (2010) Evaluation of 316 narrow diameter implants followed for 5-10 years: a clinical and radiographic retrospective study. Clinical Oral Implants Research 21, 296–307.
- Baelum, V. & Ellegaard, B. (2004) Implant survival in periodontally compromised patients. Journal of Periodontology 75, 1404–1412.
- Blanes, R. J., Bernard, J. P., Blanes, Z. M. & Belser, U. C. (2007) A 10-year prospective study of ITI dental implants placed in the posterior region. I: Clinical and radiographic results. Clinical Oral Implants Research 18, 699–706.
- Branemark, P. I., Hansson, B. O., Adell, R., Breine, U., Lindstrom, J., Hallen, O. & Ohman, A. (1977) Osseointegrated implants in the treatment of the edentulous jaw. Experience from a 10-year period. Scandinavian Journal of Plastic and Reconstructive Surgery. Supplementum 16, 1–132.
- Carcuac, O. & Jansson, L. (2010) Peri-implantitis in a specialist clinic of periodontology. Clinical features and risk indicators. Swedish Dental Journal 34, 53–61.
- Costa, F. O., Takenaka-Martinez, S., Cota, L. O., Ferreira, S. D., Silva, G. L. & Costa, J. E. (2012) Peri-implant disease in subjects with and without preventive maintenance: a 5-year follow-up. Journal of Clinical Periodontology 39, 173–181.
- De Boever, A. L., Quirynen, M., Coucke, W., Theuniers, G. & De Boever, J. A. (2009) Clinical and radiographic study of implant treatment outcome in periodontally susceptible and non-susceptible patients: a prospective long-term study. Clinical Oral Implants Research 20, 1341–1350.
- Esposito, M., Murray-Curtis, L., Grusovin, M. G., Coulthard, P. & Worthington, H. V.. (2007) Interventions for replacing missing teeth: different types of dental implants. Cochrane Database Systematic Review 17, CD003815.
- Evian, C. I., Emling, R., Rosenberg, E. S., Waasdorp, J. A., Halpern, W., Shah, S. & Garcia, M. (2004) Retrospective analysis of implant survival and the influence of periodontal disease and immediate placement on long-term results. International Journal of Oral and Maxillofacial Implants 19, 393–398.
- Fardal, O. & Grytten, J. (2013) A comparison of teeth and implants during maintenance therapy in terms of the number of disease-free years and costs – an in vivo internal control study. Journal of Clinical Periodontology 40, 645–651.
- Ferreira, S. D., Silva, G. L., Cortelli, J. R., Costa, J. E. & Costa, F. O. (2006) Prevalence and risk variables for peri-implant disease in Brazilian subjects. Journal of Clinical Periodontology 33, 929–935.
- Flemmig, T. F. (1999) Periodontitis. Annals of Periodontology 4, 32–38.
- Garcia-Bellosta, S., Bravo, M., Subira, C. & Echeverria, J. J. (2010) Retrospective study of the long-term survival of 980 implants placed in a periodontal practice. International Journal of Oral and Maxillofacial Implants 25, 613–619.
- Gianserra, R., Cavalcanti, R., Oreglia, F., Manfredonia, M. F. & Esposito, M. (2010) Outcome of dental implants in patients with and without a history of periodontitis: a 5-year pragmatic multicentre retrospective cohort study of 1727 patients. European Journal of Oral Implantology 3, 307–314.
- Gomez-Roman, G., Kruppenbacher, M., Weber, H. & Schulte, W. (2001) Immediate postextraction implant placement with root-analog stepped implants: surgical procedure and statistical outcome after 6 years. International Journal of Oral and Maxillofacial Implants 16, 503–513.
- Gomez-Roman, G., Schulte, W., d'Hoedt, B. & Axman-Krcmar, D. (1997) The Frialit-2 implant system: five-year clinical experience in single-tooth and immediately postextraction applications. International Journal of Oral and Maxillofacial Implants 12, 299–309.
- Grutter, L. & Belser, U. C. (2009) Implant loading protocols for the partially edentulous esthetic zone. International Journal of Oral and Maxillofacial Implants 24 (Suppl), 169–179.
- Hardt, C. R., Grondahl, K., Lekholm, U. & Wennstrom, J. L. (2002) Outcome of implant therapy in relation to experienced loss of periodontal bone support: a retrospective 5- year study. Clinical Oral Implants Research 13, 488–494.
- den Hartog, L., Slater, J. J., Vissink, A., Meijer, H. J. & Raghoebar, G. M. (2008) Treatment outcome of immediate, early and conventional single-tooth implants in the aesthetic zone: a systematic review to survival, bone level, soft-tissue, aesthetics and patient satisfaction. Journal of Clinical Periodontology 35, 1073–1086.
- Hermann, J. S., Cochran, D. L., Nummikoski, P. V. & Buser, D. (1997) Crestal bone changes around titanium implants. A radiographic evaluation of unloaded nonsubmerged and submerged implants in the canine mandible. Journal of Periodontology 68, 1117–1130.
- Hultin, M., Gustafsson, A. & Klinge, B. (2000) Long-term evaluation of osseointegrated dental implants in the treatment of partly edentulous patients. Journal of Clinical Periodontology 27, 128–133.
- Jemt, T. (2008) Single implants in the anterior maxilla after 15 years of follow-up: comparison with central implants in the edentulous maxilla. The International Journal of Prosthodontics 21, 400–408.
- Jung, R. E., Pjetursson, B. E., Glauser, R., Zembic, A., Zwahlen, M. & Lang, N. P. (2008) A systematic review of the 5-year survival and complication rates of implant-supported single crowns. Clinical Oral Implants Research 19, 119–130 Review.
- Karoussis, I. K., Kotsovilis, S. & Fourmousis, I. (2007) A comprehensive and critical review of dental implant prognosis in periodontally compromised partially edentulous patients. Clinical Oral Implants Research 18, 669–679.
- Karoussis, I. K., Muller, S., Salvi, G. E., Heitz-Mayfield, L. J., Bragger, U. & Lang, N. P. (2004) Association between periodontal and peri-implant conditions: a 10-year prospective study. Clinical Oral Implants Research 15, 1–7.
- Klinge, B., Meyle, J. & Working, G.. (2006) Soft-tissue integration of implants. Consensus report of Working Group 2. Clinical Oral Implants Research 17(Suppl 2), 93–96.
- Koldsland, O. C., Scheie, A. A. & Aass, A. M. (2011) The association between selected risk indicators and severity of peri-implantitis using mixed model analyses. Journal of Clinical Periodontology 38, 285–292.
- Klokkevold, P. R. & Han, T. J. (2007) How do smoking, diabetes, and periodontitis affect outcomes of implant treatment? International Journal of Oral and Maxillofacial Implants 22(Suppl.), 173–202.
- Krennmair, G., Schmidinger, S. & Waldenberger, O. (2002) Single-tooth replacement with the Frialit-2 system: a retrospective clinical analysis of 146 implants. International Journal of Oral and Maxillofacial Implants 17, 78–85.
- Krennmair, G. & Waldenberger, O. (2004) Clinical analysis of wide-diameter frialit-2 implants. International Journal of Oral and Maxillofacial Implants 19, 710–715.
- Lambrecht, J. T., Filippi, A., Kunzel, A. R. & Schiel, H. J. (2003) Long-term evaluation of submerged and nonsubmerged ITI solid-screw titanium implants: a 10-year life table analysis of 468 implants. International Journal of Oral and Maxillofacial Implants 18, 826–834.
- Lang, N. P., Berglundh, T. & Working Group 4 of Seventh European Workshop on Periodontology (2011) Periimplant diseases: where are we now?–Consensus of the Seventh European Workshop on Periodontology. Journal of Clinical Periodontology 38 (Suppl 11), 178–181.
- Lekholm, U., Gunne, J., Henry, P., Higuchi, K., Linden, U., Bergstrom, C. & van Steenberghe, D. (1999) Survival of the Branemark implant in partially edentulous jaws: a 10-year prospective multicenter study. International Journal of Oral and Maxillofacial Implants 14, 639–645.
- Levin, L., Ofec, R., Grossmann, Y. & Anner, R. (2011) Periodontal disease as a risk for dental implant failure over time: a long-term historical cohort study. Journal of Clinical Periodontology 38, 732–737.
- Lindhe, J., Meyle, J. & Group, D. o. E. W. o. P (2008) Peri-implant diseases: Consensus Report of the Sixth European Workshop on Periodontology. Journal of Clinical Periodontology 35, 282–285.
- Malo, P., de Araujo Nobre, M. & Rangert, B. (2007) Implants placed in immediate function in periodontally compromised sites: a five-year retrospective and one-year prospective study. Journal of Prosthetic Dentistry 97, S86–S95.
- Matarasso, S., Rasperini, G., Iorio Siciliano, V., Salvi, G. E., Lang, N. P. & Aglietta, M. (2010) A 10-year retrospective analysis of radiographic bone-level changes of implants supporting single-unit crowns in periodontally compromised vs. periodontally healthy patients. Clinical Oral Implants Research 21, 898–903.
- Mengel, R., Behle, M. & Flores-de-Jacoby, L. (2007) Osseointegrated implants in subjects treated for generalized aggressive periodontitis: 10-year results of a prospective, long-term cohort study. Journal of Periodontology 78, 2229–2237.
- Mengel, R., Schroder, T. & Flores-de-Jacoby, L. (2001) Osseointegrated implants in patients treated for generalized chronic periodontitis and generalized aggressive periodontitis: 3- and 5-year results of a prospective long-term study. Journal of Periodontology 72, 977–989.
10.1902/jop.2001.72.8.977 Google Scholar
- Meyle, J. (2012) Mechanical, chemical and laser treatments of the implant surface in the presence of marginal bone loss around implants. European Journal of Oral Implantology 5 (Suppl), S71–S81.
- Mir-Mari, J., Mir-Orfila, P., Figueiredo, R., Valmaseda-Castellon, E. & Gay-Escoda, C. (2012) Prevalence of peri-implant diseases. A cross-sectional study based on a private practice environment. Journal of Clinical Periodontology 39, 490–494.
- Mombelli, A. & Lang, N. P. (1998) The diagnosis and treatment of peri-implantitis. Periodontology 2000 17, 63–76.
- O'Leary, T. J., Drake, R. B. & Naylor, J. E. (1972) The plaque control record. Journal of Periodontology 43, 38.
- Perry, J. & Lenchewski, E. (2004) Clinical performance and 5-year retrospective evaluation of Frialit-2 implants. International Journal of Oral and Maxillofacial Implants 19, 887–891.
- Pjetursson, B. E., Tan, K., Lang, N. P., Bragger, U., Egger, M. & Zwahlen, M. (2004) A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years. Clinical Oral Implants Research 15, 667–676.
- Rasmusson, L., Roos, J. & Bystedt, H. (2005) A 10-year follow-up study of titanium dioxide-blasted implants. Clinical Implant Dentistry and Related Research 7, 36–42.
- Renvert, S., Lindahl, C. & Rutger Persson, G. (2012) The incidence of peri-implantitis for two different implant systems over a period of thirteen years. Journal of Clinical Periodontology 39, 1191–1197.
- Renvert, S. & Persson, G. R. (2009) Periodontitis as a potential risk factor for peri-implantitis. Journal of Clinical Periodontology 36 (Suppl 10), 9–14.
- Ricci, G., Aimetti, M., Stablum, W. & Guasti, A. (2004) Crestal bone resorption 5 years after implant loading: clinical and radiologic results with a 2-stage implant system. International Journal of Oral and Maxillofacial Implants 19, 597–602.
- Roccuzzo, M., Bonino, F., Aglietta, M. & Dalmasso, P. (2012) Ten-year results of a three arms prospective cohort study on implants in periodontally compromised patients. Part 2: clinical results. Clinical Oral Implants Research 23, 389–395.
- Roos-Jansaker, A. M., Lindahl, C., Renvert, H. & Renvert, S. (2006) Nine- to fourteen-year follow-up of implant treatment. Part I: implant loss and associations to various factors. Journal of Clinical Periodontology 33, 283–289.
- Rutar, A., Lang, N. P., Buser, D., Burgin, W. & Mombelli, A. (2001) Retrospective assessment of clinical and microbiological factors affecting periimplant tissue conditions. Clinical Oral Implants Research 12, 189–195.
- Safii, S. H., Palmer, R. M. & Wilson, R. F. (2010) Risk of implant failure and marginal bone loss in subjects with a history of periodontitis: a systematic review and meta-analysis. Clinical Implant Dentistry and Related Research 12, 165–174.
- Saxer, U. P. & Muhlemann, H. R. (1975) Motivation and education. SSO Schweiz Monatsschr Zahnheilkd 85, 905–919.
- Schou, S. (2008) Implant treatment in periodontitis-susceptible patients: a systematic review. Journal of Oral Rehabilitation 35 (Suppl 1), 9–22.
- Schou, S., Holmstrup, P., Worthington, H. V. & Esposito, M. (2006) Outcome of implant therapy in patients with previous tooth loss due to periodontitis. Clinical Oral Implants Research 17 (Suppl 2), 104–123.
- Schulte, W., d'Hoedt, B., Axmann, D. & Gómez-Román, G. (1992) 15 Jahre Tuebinger Implantat und seine Weiterentwicklung zum FRIALIT-2 System. Zeitschrift fuer Zahnärztliche Implantologie 9, 77–96.
- Simonis, P., Dufour, T. & Tenenbaum, H. (2010) Long-term implant survival and success: a 10-16-year follow-up of non-submerged dental implants. Clinical Oral Implants Research 21, 772–777.
- Strietzel, F. P., Lange, K. P., Svegar, M., Hartmann, H. J. & Kuchler, I. (2004) Retrospective evaluation of the success of oral rehabilitation using the Frialit-2 implant system. Part 1: Influence of topographic and surgical parameters. The International Journal of Prosthodontics 17, 187–194.
- Swierkot, K., Lottholz, P., Flores-de-Jacoby, L. & Mengel, R. (2012) Mucositis, peri-implantitis, implant success, and survival of implants in patients with treated generalized aggressive periodontitis: 3- to 16-year results of a prospective long-term cohort study. Journal of Periodontology 83, 1213–1225.
- Tonetti, M. S., Claffey, N. & European Workshop in Periodontology group C. (2005) Advances in the progression of periodontitis and proposal of definitions of a periodontitis case and disease progression for use in risk factor research. Group C consensus report of the 5th European Workshop in Periodontology. Journal of Clinical Periodontology 32(Suppl 6), 210–213.
Citing Literature
