maintenance fixed implants prostheses

Quintessence Int. 2014 Aug 12. doi: 10.3290/j.qi.a32566. [Epub ahead of print]

Prevalence of peri-implantitis in patients with implant-supported fixed prostheses.

Schuldt Filho G, Dalago HR, Souza JG, Stanley K, Jovanovic S, Bianchini MA.

Objective: The purpose of this study was to evaluate periimplantitis prevalence
in patients using implant-supported fixed prostheses that did not have any
routine maintenance care. Method and Materials: A total of 161 implants (27
patients) were evaluated in patients using implant-supported fixed prostheses.
Collected data included information related to patient general health and local
factors such as characteristics of implants, time in function, type of loading,
positioning, Modified Bleeding Index, bacterial plaque, bleeding on probing
(BOP), marginal recession, probing depth (PD), keratinized mucosa, and
radiographic bone loss (BL). Factors related to the prostheses were also
evaluated. The exclusion criteria were patients that have had any follow-up visit
for plaque control of the prosthesis and/or the implants. Results: From a total
of 161 implants, 116 (72%) presented without peri-implantitis (PD > 4 mm + BOP +
BL > 2 mm) while 45 (28%) had some sign of the disease. Implants placed in the
maxilla were 2.98 times more likely to develop the disease (P < .05). Moreover,
patients aged 60 years old were 3.24 times more likely to develop
peri-implantitis (P < .05). Another analysis with statistical relevance (P < .05)
was that implants with less than 3 mm interimplant distance were three times more
likely to have peri-implantitis. There was no statistical relevance considering
other analyses. Conclusion: It can be concluded that patients aged 60 years
have a greater chance of presenting periimplantitis, as well as for implants
positioned in the maxilla and those placed with an interimplant distance < 3 mm.

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J Prosthodont. 2013 Jan;22(1):28-35. doi: 10.1111/j.1532-849X.2012.00899.x. Epub 2012 Aug 31.
Maintenance of implant hybrid prostheses: clinical and laboratory procedures.
Drago C1, Gurney L.
Author information
Abstract
Fixed implant hybrid prostheses have been used for the last 40+ years in the treatment of edentulous patients.
These prostheses have provided long-term masticatory function for thousands of patients. The original
treatment protocol included fabrication of cast metal frameworks that fit accurately on the restorative
platforms or abutments and/or endosseous implants. Frameworks were designed to splint implants together;
they also provided retention and support for the functional and esthetic portions of the fixed hybrid
prostheses. Initially, edentulous patients were treated with maxillary complete dentures and mandibular fixed,
hybrid prostheses. Denture teeth were used in both prostheses. Over the span of many years, occlusal surfaces
of the denture teeth in the mandibular prostheses exhibited signs of occlusal abrasion and wear, sometimes
completely abrading the teeth and denture bases, resulting in framework exposures. Ultimately, this resulted in
decreased chewing efficiency and loss of vertical facial height. Patients would then return to clinicians and ask
for retreatment. In certain instances, the underlying frameworks would have to be remade. This involved
replicating the original series of appointments and significant additional expense to patients and clinicians
alike. The protocol presented in this article avoids having to remake the most expensive portion of fixed
implant prostheses--the frameworks. The protocol identifies the clinical and laboratory procedures involved in
using existing frameworks and replacing preexisting denture bases and denture teeth, with minimal
inconvenience to patients.


A systematic review of biologic and technical complications with fixed implant rehabilitations for edentulous
patients.
Papaspyridakos P, Chen CJ, Chuang SK, Weber HP, Gallucci GO.
Int J Oral Maxillofac Implants. 2012 Jan-Feb;27(1):102-10. Review.
Abstract
PURPOSE:
The purpose of this systematic review was to assess the incidence and types of biologic and technical
complications associated with implant-supported fixed complete dental prostheses (IFCDPs) for edentulous
patients.
MATERIALS AND METHODS:
An electronic MEDLINE/PubMED search was conducted to identify randomized controlled clinical trials and
prospective cohort studies with IFCDPs for edentulous patients. Reports with at least 5 years of follow-up after
prosthesis insertion were selected. Pooled data were analyzed statistically, and the cumulative complication
rates were calculated by meta-analysis and regression.
RESULTS:
Of a total of 281 one-piece IFCDPs (mean exposure time of 9.5 years) and 653 complication events, the
complication rate was estimated at 24.6% per 100 restoration-years. The cumulative rates of "prosthesis free
of complications" after 5 and 10 years were 29.3% and 8.6%, respectively. The most common implantrelated
biologic complication was peri-implant bone loss (> 2 mm), at rates of 20.1% after 5 years and 40.3% after 10
years. The most frequent implant-related technical complication was screw fracture, yielding a 5-year
complication rate of 10.4% and a 10-year rate of 20.8%. The most frequent prosthesis-related biologic
complication was hypertrophy or hyperplasia of tissue around the IFCDPs (13.0% and 26.0% after 5 and 10
years, respectively). The most common prosthesis-related technical complication reported with IFCDPs was
chipping or fracture of the veneering material (33.3% at 5 years and 66.6% at 10 years).
CONCLUSION:
Biologic and technical complications after the placement of IFCDPs occur continuously over time as a result of
fatigue and stress. These events may not lead to implant/prosthetic failures, but they are significant in relation
to the amount of repair and maintenance needed, time, and cost to both the clinician and patient.


Implant treatment with fixed prostheses in the edentulous maxilla. Part 2: prosthetic technique and clinical
maintenance in two patient cohorts restored between 1986 and 1987 and 15 years later.
Jemt T, Stenport V.
Int J Prosthodont. 2011 Jul-Aug;24(4):356-62.

Int J Prosthodont. 2011 Jul-Aug;24(4):356-62.
Implant treatment with fixed prostheses in the edentulous maxilla. Part 2: prosthetic technique and clinical
maintenance in two patient cohorts restored between 1986 and 1987 and 15 years later.
Jemt T, Stenport V.
Abstract
Purpose: Implant treatment using osseointegrated implants has been performed for more than 40 years, but
limited knowledge is available on how treatment outcomes have changed over time. The aim of this study was
to report and compare the prosthetic treatment outcomes from two patient cohorts provided with fixed
implant prostheses in the edentulous maxilla between 1986 and 1987 (early) and 2001 to 2004 (late) at the
same clinic. Materials and Methods: The two groups of patients comprised 76 and 109 edentulous patients
consecutively provided with 450 and 670 Branemark System implants and fixed screw-retained prostheses,
respectively. Both groups were followed for 5 years with regard to prosthetic treatment, clinical maintenance,
and complications. Results: Altogether, 37 patients (20%) were lost to follow-up during the 5 years, and more
patients were noncompliant in the late group (P < .05). Prosthetic treatment was performed using significantly
less chair time in the late group (P < .05), and 22 and 68 patients were followed for 5 years without any
reported complications in the early and late groups, respectively (P < .05). The 5-year prosthesis cumulative
survival rate was 97.1% in the early group and 100.0% in the late group. Patients in the late group presented
fewer problems with diction and veneer fractures, and fewer patients had their prostheses temporarily
removed for adjustments (P < .05). Conclusion: Prosthetic treatment and maintenance of implant-supported
fixed prostheses improved significantly between the groups. Int J Prosthodont 2011;24:356-362.
Technical and biological complications fixed implants prostheses

Clin Oral Implants Res. 2012 Oct;23 Suppl 6:63-5. doi: 10.1111/j.1600-0501.2012.02557.x.
Implant survival and complications. The Third EAO consensus conference 2012.
Albrektsson T
1
, Donos N; Working Group 1.
Collaborators (17)
Author information
Abstract
OBJECTIVES:
The task of this working group was to analyze biological, technical and aesthetic complications of single
crowns on implants and fixeddental prostheses with or without cantilevers on implants over 5 years or
more. In addition, the group analyzed economic aspects on such implant treatment.
MATERIALS AND METHODS:
A systematic search of the relevant literature was conducted and critically reviewed. Four manuscripts were
presented to cover the topics.
RESULTS:
The consensus statements prepared by the group and later accepted at the plenary session as well as
suggestions for future research are presented in this article. The four reviews by Jung et al., Pjetursson et
al., Romeo & Storelli and Scheuber et al. are printed separately and present detailed analyses of the
research topics.

Waterpik
Quantitative evaluation of the oral biofilm-removing capacity of a dental
water jet using an electron-probe microanalyzer.
Kato K, Tamura K, Nakagaki H.
Arch Oral Biol. 2012 Jan;57(1):30-5. doi: 10.1016/j.archoralbio.2011.08.006. Epub 2011
Sep 13.
PMID: 21920496 [PubMed - indexed for MEDLINE]
Related citations
Select item 20579423

2.
The dental water jet: a historical review of the literature.
Jahn CA.
J Dent Hyg. 2010 Summer;84(3):114-20. Epub 2010 Jul 5. Review.
PMID: 20579423 [PubMed - indexed for MEDLINE]
Related citations
Select item 19385349

3.
Biofilm removal with a dental water jet.
Gorur A, Lyle DM, Schaudinn C, Costerton JW.
Compend Contin Educ Dent. 2009 Mar;30 Spec No 1:1-6.
PMID: 19385349 [PubMed - indexed for MEDLINE]

https://www.dentalaegis.com/special-issues/2009/03/biofilm-removal-with-a-dental-water-
jet
Clin Oral Implants Res. 2009 Feb;20(2):169-74. doi: 10.1111/j.1600-0501.2008.01627.x. Epub
2008 Dec 1.
Peri-implantitis in partially edentulous patients: association
with inadequate plaque control.
Serino G1, Strm C.
Author information


Abstract
OBJECTIVE:
The aim of the present study was to describe some clinical periodontal features of
partially edentulous patients referred for the treatment of peri-implantitis.
MATERIAL AND METHODS:
The 23 subjects involved in this study were selected from consecutive patients
referred to the department of Periodontology Sdra Alvsborgs Hospital, Bors,
Sweden, for treatment of peri-implantitis during 2006. The patients had clinical
signs of peri-implantitis around one or more dental implants (i.e.>or=6 mm
pockets, bleeding on pockets and/or pus and radiographic images of bone loss
to>or=3 threads of the implants) and remaining teeth in the same and/or opposite
jaw. The following clinical variables were recorded: Plaque Index (PI), Gingival
Bleeding Index (GBI) Probing Pocket Depth (PPD), Access/capability to oral
hygiene at implant site (yes/no), Function Time. The patients were categorized in
the following sub-groups: Periodontitis/No periodontitis, Bone loss/No bone loss at
teeth, Smoker/Non-smokers.
RESULTS:
Out of the 23 patients, the majority (13) had minimal bone loss at teeth and no
current periodontitis; 5 had bone loss at teeth exceeding 1/3 of the length of the
root but not current periodontitis and only 5 had current periodontitis. Six patients
were smokers (i.e. smoking more than 10 cig/day). The site level analysis showed
that only 17 (6%) of the 281 teeth present had >or=1 pocket of >or=6mm,
compared to 58 (53%) of the total 109 implants (28 ITI and 81 Brnemark); 74% of
the implants had no accessibility to proper oral hygiene. High proportion of
implants with diagnosis of peri-implantitis were associated with no
accessibility/capability for appropriate oral hygiene measures, while
accessibility/capability was rarely associated with peri-implantitis. Indeed 48% of
the implants presenting peri-implantitis were those with no accessibility/capability
for proper oral hygiene (65% positive predict value) with respect to 4% of the
implants with accessibility/capability (82% negative predict value).
CONCLUSION:
The results of the study indicate that local factors such as accessibility for oral
hygiene at the implant sites seems to be related to the presence or absence of
peri-implantitis. Peri-implantitis was a frequent finding in subjects having signs of
minimal loss of supporting bone around the remaining natural dentition and no
signs of presence of periodontitis (i.e. presence of periodontal pockets of >or=6
mm at natural teeth). Only 6 of the examinated subjects were smokers. In view of
these results we should like to stress the importance of giving proper oral hygiene
instructions to the patients who are rehabilitated with dental implant and of proper
prosthetic constructions that allow accessibility for oral hygiene around implants.