Osseointegrated Implants in Patients with Periodontal Diseases

Osseointegrated Implants in Patients with Periodontal Diseases
R. MENGEL, and L. FLORES-DE-JACOBY, Dental School of Medicine, Marburg, Germany
2003
IADR
Objectives: The aim of the prospective study of 15 patients treated for generalized aggressive periodontitis (GAP), 12 patients treated for generalized chronic periodontitis (GCP), and 12 periodontally healthy patients was a clinical, microbiological and radiographic comparison of teeth and implants, and assessment of the implant success rate. Methods: 39 partially edentulous patients provided with a total of 150 implants (Br?īnemark, Astra, Osseotite) were enrolled in the study. The clinical examination comprised: PlI, GI, AL, PPD. The microflora was determined by dark-field microscopy and DNA analysis. The parameters were recorded immediately before implantation, before integration of the superstructure, and then every 3 months for 3 years. In addition, the teeth and implants were x-rayed. Statistical analysis was based on the paired t-test, Spearman's test, other t-tests and Kaplan-Meier test. Results: The clinical parameters indicated healthy conditions in all patient groups. The GI and PlI at implants and teeth remained below 0.25 and 0.6 respectively throughout, while the PPD at the teeth remained constant in all groups. At the implants, a slight increase in PPD (< 1 mm) was recorded in the GAP patients. The attachment loss was greater at the implants than at the teeth in all patient groups. In the GAP patients, it was ca. 1.5 mm, with a continuous increase being recorded each year. The distribution of the microorganisms revealed healthy conditions in all patient groups. Bone loss was higher after 3 years at implants and teeth in the GAP patients: 1.14 mm at implants and 3.48% at teeth. The implant success rates recorded were 100% in the periodontally healthy and GCP patients, and 97.4% in the GAP patients. Conclusions: The results revealed a continuous attachment loss and bone loss at the implants in the GAP patients. The long-term prognosis of the implant success is thus open to question.