Peri-İmplant Hastalıklar ile İlişkili Risk Faktörlerinin Periodontal, Protetik ve Radyolojik Olarak Değerlendirilmesi

Abstract

With the increasing popularity of dental implant treatment, there has been a corresponding rise in the prevalence of diseases affecting peri-implant tissues. It is crucial to identify potential risk factors associated with peri-implant diseases to prevent their occurrence and contribute to their management. The objective of this study is to comprehensively evaluate the current clinical and radiographic status of individuals who have undergone implant therapy and examine all possible risk factors, as documented in the literature, encompassing individual, prosthetic, and local factors. The aim is to identify and interpret factors crucial for the development of peri-implantitis. The study included a total of 50 patients, comprising 30 females and 20 males, with a total of 249 implants. These implants were categorized into four groups based on the health status of the peri-implant tissues: peri-implant health (n=33), peri-implant mucositis (n=137), peri-implantitis (n=51), and hard and soft tissue insufficiency (n = 28). Relevant periodontal, prosthetic, and radiological parameters were recorded for each implant. The evaluations revealed significant differences among diagnostic groups in terms of patient age, implant placement site, implant length and type, smoking history, periodontitis history, periodontal diagnoses, periodontitis stages, participation in maintenance therapy, and interproximal cleaning habits (p<0.05). Significant differences were also observed among diagnostic groups for all periodontal parameters except plaque index (p<0.05). Regarding prosthetic parameters, significant differences were noted among diagnostic groups for opposing arch tooth prosthetic conditions, types of prosthetic retainers on implants, connection types, prosthetic cleanability, and step fits of prostheses. Significant differences were observed among diagnostic groups in digital radiographic evaluations, particularly in marginal bone loss and measurements of distances between prosthetic margins and bone crests. To create a risk factor analysis model, the Generalized Estimating Equations (GEE) approach was preferred as the analysis method suitable for the dataset. The risk analysis model indicated that placing implants in the maxillary bone compared to the mandibular bone carries a 17.3% higher risk of peri-implantitis, and the risk of peri-implantitis is 26.1% higher when prostheses on implants do not allow patient cleaning compared to those that do. While interpreting these results, it should be considered that the limited number of participants and the imbalance in the distribution of implant numbers among diagnostic groups are restricting factors in our study. Further advanced studies with larger sample sizes are needed for a more comprehensive evaluation of risk factors based on the results of the risk analysis.