Patient- and implant-level factors associated with peri-implant diseases: a retrospective clinical and radiographic study of 968 implants
摘要
Peri-implant diseases are among the most clinically significant biological complications of implant therapy, yet the relative contribution of patient- and implant-related factors to their development remains incompletely understood. This retrospective study examined the associations between demographic, clinical, and implant-related variables and peri-implant disease status in a large clinical cohort.
MethodsA total of 199 patients with 968 dental implants placed between January 2015 and January 2023 were evaluated. Variables recorded included demographic characteristics, systemic conditions, smoking status, oral hygiene habits, implant-related parameters, clinical indices (plaque index, gingival index, probing depth, attached gingiva width, and gingival thickness), and radiographic marginal bone loss. Peri-implant disease status — classified as peri-implant health, peri-implant mucositis, or peri-implantitis according to the 2017 World Workshop criteria — was the primary outcome. Multivariable generalized estimating equations (GEE) models were applied to account for the clustering of multiple implants per patient.
ResultsOf the 968 implants, 713 (73.6%) were classified as peri-implant health, 173 (17.9%) as peri-implant mucositis, and 82 (8.5%) as peri-implantitis. In multivariable GEE analysis, smoking ≥ 10 cigarettes/day (OR = 2.55, 95% CI: 1.07–6.10 for mucositis; OR = 4.40, 95% CI: 1.60–12.08 for peri-implantitis), inadequate tooth brushing (OR = 4.65, 95% CI: 1.99–10.86; OR = 5.90, 95% CI: 2.21–15.77), and thin gingival phenotype (OR = 4.22, 95% CI: 2.09–8.51; OR = 15.64, 95% CI: 6.08–40.23) were independently associated with both conditions. Longer implant functional duration was additionally associated with peri-implantitis (OR = 1.57, 95% CI: 1.30–1.90; p < 0.001).
ConclusionWithin the limitations of this retrospective study, smoking, inadequate oral hygiene, thin gingival phenotype, and longer implant functional duration were independently associated with peri-implant diseases. These findings suggest that peri-implant soft tissue assessment and patient-level risk assessment should be integral components of long-term implant maintenance protocols.