Untreated peri-implant mucositis …

PD Dr. Kristina Bertl, PhD MSc MBA

We know what we should do after the patient has been fitted with their implant-support prosthesis, but if our approach is less than strict, what actually happens? What happen to patients who have peri-implant mucositis but are nonetheless not included in a regular follow-up programme?

A Brazilian research group investigated this very question (Costa et al. 2012). Over the course of 5 years, they followed 80 patients who all exhibited peri-implant mucositis at the start of the study. Half of patients regularly came to follow-up sessions, while the other half did not regularly attend the recommended appointments. In this study, ‘regularly’ was defined as at least once per year in each of the 5 years

At the end of the study, the following division was observed in the group that did regularly attend follow-up sessions:
Peri-implant health: 30.5%
Peri-implant mucositis: 51.5%
Peri-implantitis: 18.0%

At the end of the study, the following division was observed in the group that did not regularly attend follow-up sessions:
Peri-implant health: 0%
Peri-implant mucositis: 56.1%
Peri-implantitis: 43.9%

These figures very clearly show that patients with peri-implant mucositis have a very high risk of developing peri-implantitis if they remain untreated. Indeed, almost half of the patients who did not attend follow-up sessions had peri-implantitis instead of peri-implant mucositis after 5 years! In statistical terms, their risk of developing peri-implantitis was 6 times higher. Furthermore, the results from this patient group confirmed once again that having periodontitis is a risk factor; having periodontitis increased the risk of developing peri-implantitis by 9 fold!

This study again indicates the importance of regular follow-up sessions, particularly for patients who already have peri-implant mucositis. And if we encourage our patients to attend follow-up appointments right from the start and on a regular basis from then on, we can also achieve very high rates of compliance (‘Compliance after the implant-supported restoration – yes or no?’).

Reference

1. Costa FO, Takenaka-Martinez S, Cota LOM, Ferreira SD, Silva GLM, Costa JE, Peri-implant disease in subjects with and without preventive maintenance: a 5-year follow-up. J Clin Periodontol 2012; 39: 173–181. doi: 10.1111/j.1600-051X.2011.01819.x.