Khaldoun Darwich DMD and Felix Blake MD, DMD
Aim:
The implementation of dental implants is finding increasing acceptance for the oral rehabilitation in the field of dentistry as well in craniofacial surgery for the fixation of intraoral and extraoral prostheses. The advantages of this procedure are well known and documented in the medical literature, being the only method which facilitates a force transduction into the bone, mitigating the bone atrophy due to loss of function [Branemark et al. 1982].
This also holds true for implants inserted in transplanted bone, proving to be osteoprotective. One problem encountered is that endosteal implants are susceptible for bacterial colonisation with subsequent periimplantary inflammation, which could negatively influence the prognosis or life expectancy of an implant. Knowledge of the etiology, progress and expression of the periimplantitis and the effects on the transplanted bone is vital to promote an adequate therapy.
Materials and Methods:
The retrospective investigation involved 52 patients (25 males, 27 females) who were treated at the department of Maxillofacial Surgery of the University Medical Center Hamburg-Eppendorf between the years 1994 and 2003. A total of 214 implants were included in the investigation.
Results:
122 implants (57%), showed no signs of inflammation, 42 (20%) suffered from periimplantary mucositis and by 50 (23%) fully manifested Periimplantitis was evident.
Discussion:
Decisive for the development of periimplantary inflammation is an insufficient oral hygiene allowing plaque accumulation on the implants surface. In conjunction with other local or general factors like overloading or systemic diseases like diabetes mellitus or smoking, the course can be accelerated. Following bone transplantation and implantation further factors influence the prognosis of the implants like the general condition of the patient (e.g. age, compliance), therapies experienced (radiotherapy, chemotherapy) and the nature of the bone transplant (free bone transplant, revascularised transplant). Nonetheless, periimplantitis is not an inevitable event and if certain rules are followed along the entire course of treatment (correct planning, hygiene instructions, stringent recall system) the life expectancy of the implants as well as the bone transplant can be considered as very good, easily exceeding 10 years and more [Adell et al. 1981].
Key words:
dental implants, periimplantitis, jaw reconstruction
