Search

Peri-implant diseases are defined as bacterial plaque-induced inflammatory conditions affecting implant-surrounding tissues and are classified as peri-implant mucositis and peri-implantitis. Peri-implant mucositis is characterized by an inflammatory lesion that resides in the soft tissue compartment, whereas at peri-implantitis sites the lesions also feature progressive loss of implant-supporting bone. Inflammation resolution and disease progression arrestment are the main therapeutic endpoints of the treatment of peri-implant diseases. The present position paper displays the current evidence and clinical recommendations of the European Association for Osseointegration for the treatment of peri-implant diseases. Mechanical biofilm removal along with the reinforcement of patient-administered oral hygiene is considered the standard treatment for managing peri-implant mucositis. It is recommended to assess the outcomes of peri-implant mucositis treatment 2 to 3 months after therapy, and repeated intervention should be considered in the absence of treatment success. Peri-implantitis treatment should follow a stepwise treatment approach, starting with nonsurgical treatment followed by surgical intervention, if that is not sufficient. Surgical peri-implantitis therapies include nonreconstructive, reconstructive, and combined treatment modalities. Implantoplasty may be advocated for the treatment of supracrestal peri-implant defects, whereas reconstructive therapy is indicated at peri-implantitis sites featuring intraosseous defects with a depth ≥ 3 mm. Adjunctive reconstructive measures may be beneficial in enhancing radiographic defect fill and maintaining postoperative soft tissue levels, which may have a great impact in esthetic cases. The adjunctive use of systemic antibiotics during surgical therapy does not seem to improve the clinical outcomes. Regular supportive peri-implant therapy with biofilm removal should be an integral part of the treatment protocol for peri-implant diseases. In the presence of advanced bone loss around implants that do not play a strategic role in masticatory function, implant removal may be considered immediately. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the soft tissue response to the placement of additively manufactured subperiosteal jaw implants (AMSJI) in the severely atrophic maxilla and to identify possible risk factors for soft tissue breakdown. Materials and Methods: An international multicenter study was conducted, and 15 men (mean age: 64.62 years; SD: ± 6.75) and 25 women (mean age: 65.24 years; SD: ± 6.77) with advanced maxillary jaw resorption (Cawood and Howell Class V or more) were included in this study. General patient data were collected, and all subjects were clinically examined. Inclusion criteria were patients who underwent bilateral AMSJI placement in the maxilla at least 1 year prior. Exclusion criteria were patients who did not have patient, surgeon, or dentist consent to participate in the study before their inclusion. Results: A total of 40 patients were enrolled, with a mean follow-up period of 917 days (SD: ± 306.89 days). Primary implant stability was achieved postoperatively in all cases, and all implants were loaded with a final prosthesis. At the time of the study, only 1 patient showed mobility (> 1 mm) of the bilateral AMSJI. Due to mucosal recession, exposure of the framework was seen in 26 patients (65%) and was mainly in the left (21.43% of 26) and right (18.57% of 26) midlateral region. A thin biotype and the presence of mucositis were found to be risk factors (P < .05). Although not significant, smokers had a risk of developing a recession that was nearly seven times (odds ratio: 6.88; P = .08) greater than that of nonsmokers. Conclusions: Twenty-six (65%) patients presented with a recession in one (or more) of the seven regions after oral rehabilitation with bilateral AMSJI placement. Several risk drivers were evaluated. The collapse of soft tissues around the AMSJI that led to caudal exposure of the arms was correlated with a thin biotype and the presence of mucositis. [ABSTRACT FROM AUTHOR]