Research On The Prevalence And Related Factors For Peri-implantitis

AimPeri-implantitis(PI)is a common biological complication after dental implant surgery.we explored the effect of local and systemic factors on PI and calculated the prevalence of PI after medical records review,questionnaire survey,oral and peri-implant examinations of recalled patients,these results may provide a reference for clinical treatment and epidemiology study.MethodsFrom December 2020 to June 2021,this study randomly recalled patients whose implants were placed and restored in SATH Hospital of Stomatology,Henan University and all patients met the inclusion criteria.We reviewed the patients’ medical history,asked them to fill in a questionnaire and performed the oral and radiographic examination on these patients,then systemic factors and local factors were recorded.PI was diagnosed according to the 2018 New International Classification of peri-implant diseases,and the prevalence of PI was calculated.The biological parameters of PI and peri-implant mucositis(PM),including probing depth(PD),bleeding on probing,suppuration and peri-implant bone loss(BL),were described and compared.Patient-related factors and implant-related factors were analyzed with IBM SPSS Statistics 24 software.In univariate analysis,quantitative variables were analyzed by Student’s t-test or Mann Whitney U-test,and qualitative variables were analyzed by chi square test.The factors included: age,gender,without preventive maintenance,the staging and grading of periodontitis,history of hypertension,history of cardiac disease,history of diabetes,history of smoking,history of drinking,implant position,keratinized gingival width,number of implant supported crowns,cemented retained restorations,dental implant plaque index(PLI),guidance bone regeneration(GBR),maxillary sinus floor elevation(MSFE),implant length,implant diameter,implant area bone defect,implant system,implant function time and oral hygiene habits,etc.Multivariate analysis used logistic regression to analyze the independent risk factors of PI.Results(1)A total of 226 patients(122 men and 104 women)and 489 bone level implants were included in the study.The mean age of the patients was 54.48 years.The average implant loading time was 3.27 years.The prevalence of PI at patient level and implant level were 19.5% and 12.7%,respectively.The prevalence of PI increased linearly within 1-3 years after dental prostheses delivered,and it was tending towards stability after third years of implant functional loading.(2)In patient level univariate analysis,there was a significant association between the staging(P=0.001)and grading(P=0.000)of periodontitis and PI.The prevalence of PI increased with the severity and the progression rate of periodontitis.According to the questionnaire interview data,patients without preventive maintenance(P=0.032),diabetes(P=0.016)and cardiac disease(P=0.038)had more risk for PI.29.5% of PI patients felt implant swelling and bleeding and 18.2% of patients with PI felt implant chewing discomfort.61.4% of PI patients had no symptoms.Logistic regression analysis only showed that severe periodontitis(OR = 2.720)significantly increased the risk of PI.(3)In implant level univariate analysis,PI was associated with PLI≥2,width of keratinized gingiva≤2mm,number of implants supported crowns,MSFE,bone height<10mm,mechanical complications and implant function time.Implant level logistic regression analysis showed that PLI≥2(P=0.001,OR=3.011,95%CI: 1.556～5.826),width of keratinized gingiva≤2mm(P=0.018,OR=2.034,95%CI: 1.127～3.673)and the number of implants supported crowns>2(P=0.044,OR=2.264,95%CI:1.023～5.010)had more risk of developing PI.Conclusions(1)The prevalence of PI at patient level and implant level were 19.5% and 12.7%,respectively.The prevalence of PI increased linearly within 1-3 years after dental prostheses delivered,and it was tending towards stability after third years of implant functional loading.(2)Most patients with PI didn’t have any conscious symptoms.A small number of PI patients felt implant swelling and bleeding or implant chewing discomfort.Patients need regular maintenance after implant restoration,and fight for early discovery,early diagnosis and early treatment of peri-implant diseases.(3)Implant level analysis showed that when the plaque around the implant can be seen with the naked eye and keratinized gingiva width was insufficient,implants were more susceptible to peri-implantitis.Severe periodontitis(OR = 2.720)significantly increased the risk of PI.And the prevalence of PI increased with the increase of the severity and progression of periodontitis.After restoration,patients need to maintain oral hygiene and periodontal health to keep peri-implant healthy.(4)The number of implants supported crowns>2 had more risk of developing PI.The number of implants supported dental crowns should be considered in the design of prostheses and prevent implant overload.Plaque is easy to deposit on the tissue surface of long fixed bridge.Patients should be taught correct implant maintenance methods in clinical practice.