InquiryPlacing implants in a periodontally compromised patient
Section snippets
Background
Dental implants are a good option for replacing missing teeth, offering high rates of success. However, implant-based restorations continue to require long-term maintenance, especially in patients who have a history of periodontal disease, to avoid the development of significant morbidities such as peri-implantitis. Tooth loss often occurs because of periodontal disease, so patients with a history of periodontal disease are drawn to implant therapy to replace lost dentition. The evidence
Periodontal Disease Facts
Moderate periodontal disease is found in 40% to 80% of the population. About 10% develop severe chronic periodontitis (CP) and 4% develop aggressive periodontitis (AgP). CP has a slowly progressive course with short periods of rapid progression. In contrast, AgP is characterized by rapid loss of attachment and bone destruction, runs in families, and is found most often in persons under age 30 years.
Implants and Peri-implantitis
Implants are highly successful, but can fail because of complications related to technical and biological factors. Technical factors are the most common cause of failure and include loosening or fracture of the abutment screw, failure of implant-retained prostheses, and fracture of the implant fixture. Biological complications are related to inflammation and destruction of the peri-implant tissues. The inflammation is related to improper site placement, peri-mucositis, residual cement,
Risks with Implants in Patients with Periodontitis
Six systematic reviews have provided information about the outcomes of dental implants in patients who have a history of periodontitis.
- 1.
Patients with CP have a significantly greater rate of peri-implantitis at 10 years and peri-implant bone loss after 5 years compared to periodontally healthy patients.
- 2.
Implant survival is lower for patients whose periodontitis was treated than for periodontally healthy individuals.
- 3.
Periodontitis patients have more marginal bone loss than periodontally healthy
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King E, Patel R, Patel A, et al: Should implants be considered for patients with periodontal disease? Br Dent J 331:705-711, 2016
Reprints available from E King, Speciality Registrar in Restorative Dentistry, Morriston Hosp, Heol Maes Eglwys, Morriston, Swansea, SA6 6NL; e-mail: [email protected]