11.25.23 Rafael_peri-implant mucositis

Question 1

What is peri-implant health?

Answer 1

• Absence of clinical signs of inflammation, profuse BOP.
• PD: It is “not possible to define a range compatible with health.” However, PD is generally ≤5mm
• Absence of further bone loss after initial healing (<2mm)
• NOTE: the bone loss was later modified to 3mm after 1 year of prosthesis loading

Question 2

What is peri-implantitis? (Definition)

Answer 2

• Clinical signs of inflammation are present (erythema, swelling, BOP and/or suppuration)
• PD ≥6mm
• Bone levels ≥3 mm apical to the implant platform (12 months after the implant was placed)

Question 3

What is the prevalence of peri-implant mucositis?

Answer 3

Lindhe - Consensus report of the 6th european workshop on Periodontology
Peri-implant mucositis: ~80% of subjects (50% of sites)
Peri-implantitis: 28-56% of subjects (12-40% of sites)

and
Koldslan: [Add here]

Derks & Tomasi 2016 JDR:
Per-implant mucositis: 43%
Peri-implantitis: 22%
= however, this was a Swedish study, using Tissue level implants

Question 4

Is peri-implant mucositis reversible?

Answer 4

Salvi 2012 Yes, it is reversible at the biomarker level. However, clinically, 3 weeks of plaque control did not yield pre-levels of health.

Question 5

What are risk indicators of peri-implant mucositis?

Answer 5

Heitz-Mayfield 2018
Systemic:
* smoking
* poorly controlled diabetes
* radiation therapy
* gender
* function time of the implants
Local:
* Poor oral hygiene
* Lack of compliance
* Implant surface characteristics
* Prosthesis design
* KTW
* Excess cement

Question 6

Is an electric toothbrush effective in cleaning dental implants?

Answer 6

Swierkot 2013, Eur J Oral Implantology
Manual vs. sonic toothbrush in plaque reduction: NSSD

Allocca 2018, Int J Impl Dentistry
SSD between oscilating-rotating and manual toothbrush. (Electric toothbrush is better)

Question 7

When comparing tools for peri-implant cleaning, which did Dr. Sirinirund find is most effective?

Answer 7

Floss & Superfloss

Question 8

Describe the Louropoulou 2014 study

Answer 8

[Add here]

Question 9

For peri-implant mucositis, should adjunctive treatments be used (in addition to SRP)?

Answer 9

Barootchi 2020 - SRP alone can be considered the standard for peri-implant mucositis, due to lack of evidence supporting use of additional adjunctives.

Ramanauskaite 2021 - Adjuncts and alternatives provide no additional benefits.

Lin 2016 - The limited number of studies with scare data on adjunctive laser therapy for treatment of peri-implant mucositis makes it difficult to warrant their therapeutic values

Figuero 2014 - Peri-implant mucositis seems to be successfully treated by professional mechanical debridement, independently of the adjunctive use of an antimicrobial.
At home, mechanical plaque control, together with the use of an antiseptic, may provide benefit in the
treatment of peri-implant mucositis in terms of reduction of bleeding on probing and sometimes in
reduction of the plaque index.

Philip 2022 To assess the microbial effects of mechanical debridement + mouthrinses in peri-implant mucositis and gingivitis
* 0.2% Delmopinol
* 0.2% chlorhexidine
* Placebo rinse
Findings: Adjunctive antimicrobial therapy does affect both dental and peri-implant biofilm composition in the short term, resulting in a less dysbiotic sub-gingival biofilm. These microbiological effects are not reflected in the clinical response.

Question 10

How often should mucositis patients be seen for maintenance?

Answer 10

Monje - every 5 to 6 months, need to see the patient for maintenance
(according to Dr. Wang)

Frisch 2020 Patients without regular maintenance might exhibit a 4.25-fold increased risk for peri-implantitis.