Relationship between Peri-Implant Clinical Parameters and Increased Probing Depth in Dental Implants: A Cohort Study

Abstract

Background: Peri-implantitis has been defined as an inflammatory lesion of the mucosa surrounding an endosseous implant and with progressive loss of supporting peri-implant bone. The peri-implant health consists of the absence of visual signs of inflammation and the absence of bleeding and/or suppuration after gentle probing, with no increase in the probing depth in comparison to prior exams. Aims: The gradual increase in probing depth makes it more difficult to keep the subgingival region healthy, patients should be instructed on how to clean the areas rehabilitated with dental implants, and most professionals still have doubts about the diagnosis and treatment of peri-implantitis. Methodology: This Cohort study carried out at Department of Dentistry University Santo Amaro, São paulo, Brazil, between June 2019 and July 2021. Initially, 208 patients who underwent oral rehabilitation with implants between 2011 and 2012. After defining the eligibility criteria, 73 patients with one unitary external hexagon implant in function for 10 years were included in the study.  Participants underwent complete peri-implant examination and were evaluated: probing depth, plaque index, bleeding index and suppuration. Periapical radiographs were taken to verify the current bone level. Results: Peri-implantitis was diagnosed in 37 implants (50.7%) and 36 (49.3%) were healthy.  The 37 implants diagnosed with peri-implantitis were influenced by the plaque index and the interaction between probing depth and suppuration (P < .001). The bone loss for implants diagnosed with peri-implantitis, the average was 4.0 mm (P < .001). For plaque index, the average was 3.6 mm (P < .001) and the average for suppuration as 4.0 mm. The implant was diagnosed with peri-implantitis, and the presence of biofilm has affected the PD. Conclusion: Within the limitations of this cohort study, increased plaque index and suppuration were significantly associated with peri-implantitis. Prospective studies with baseline measurements should be performed to elucidate the role of biofilm in peri-implantitis.  Biofilm control is essential for the preservation of peri-implant tissues and, depending on the microorganisms involved, host response and other factors such as smoking, diabetes, and inadequate hygiene, we may have the development of disease.