Long-Term Effect of Surface Roughness and Patients' Factors on Crestal Bone Loss at Dental Implants. A Systematic Review and Meta-Analysis

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Abstract

Publications from 2011 to 2015 were selected to evaluate effect of implant surface roughness on long-term bone loss as surrogate for peri-implantitis risk. 87 out of 2,566 papers reported the mean bone loss after at least 5 years of function. Estimation of the proportion of implants with bone loss above 1, 2, and 3 mm as well as analysis the effect of implant surface roughness, smoking, and history of periodontitis was performed. By means of the provided statistical information of bone loss (mean and standard deviation) the prevalence of implants with bone loss ranging from 1 to 3 mm was estimated. The bone loss was used as a surrogate parameter for "peri-implantitis" given the fact that "peri-implantitis" prevalence was not reported in most studies or when reported, the diagnostic criteria were unclear or of dubious quality. The outcome of this review suggests that peri-implant bone loss around minimally rough implant systems was statistically significant less in comparison to the moderately rough and rough implant systems. No statistically significant difference was observed between moderately rough and rough implant systems. The studies that compared implants with comparable design and different surface roughness, showed less average peri-implant bone loss around the less rough surfaces in the meta-analysis. However, due to the heterogeneity of the papers and the multifactorial cause for bone loss, the impact of surface roughness alone seems rather limited and of minimal clinical importance. Irrespective of surface topography or implant brand, the average weighted implant survival rate was 97.3% after 5 years or more of loading. If considering 3 mm bone loss after at least 5 years to represent the presence of "peri-implantitis," less than 5% of the implants were affected. The meta-analysis indicated that periodontal history and smoking habits yielded more bone loss.

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Effect of material characteristics and/or surface topography on biofilm development.

Wim Teughels, Nele Van Assche, Isabelle Sliepen … (2006)

From an ecological viewpoint, the oral cavity, in fact the oro-pharynx, is an 'open growth system'. It undergoes an uninterrupted introduction and removal of both microorganisms and nutrients. In order to survive within the oro-pharyngeal area, bacteria need to adhere either to the soft or hard tissues in order to resist shear forces. The fast turn-over of the oral lining epithelia (shedding 3 x/day) is an efficient defence mechanism as it prevents the accumulation of large masses of microorganisms. Teeth, dentures, or endosseous implants, however, providing non-shedding surfaces, allow the formation of thick biofilms. In general, the established biofilm maintains an equilibrium with the host. An uncontrolled accumulation and/or metabolism of bacteria on the hard surfaces forms, however, the primary cause of dental caries, gingivitis, periodontitis, peri-implantitis, and stomatitis. This systematic review aimed to evaluate critically the impact of surface characteristics (free energy, roughness, chemistry) on the de novo biofilm formation, especially in the supragingival and to a lesser extent in the subgingival areas. An electronic Medline search (from 1966 until July 2005) was conducted applying the following search items: 'biofilm formation and dental/oral implants/surface characteristics', 'surface characteristics and implants', 'biofilm formation and oral', 'plaque/biofilm and roughness', 'plaque/biofilm and surface free energy', and 'plaque formation and implants'. Only clinical studies within the oro-pharyngeal area were included. From a series of split-mouth studies, it could be concluded that both an increase in surface roughness above the R(a) threshold of 0.2 microm and/or of the surface-free energy facilitates biofilm formation on restorative materials. When both surface characteristics interact with each other, surface roughness was found to be predominant. The biofilm formation is also influenced by the type (chemical composition) of biomaterial or the type of coating. Direct comparisons in biofilm formation on different transmucosal implant surfaces are scars. Extrapolation of data from studies on different restorative materials seems to indicate that transmucosal implant surfaces with a higher surface roughness/surface free energy facilitate biofilm formation.

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Paolo Trisi, Hom-Lay Wang, J. Choukroun … (2008)

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Clinical research on peri-implant diseases: consensus report of Working Group 4.

Mariano Sanz, Iain Chapple (2012)

Two systematic reviews have evaluated the quality of research and reporting of observational studies investigating the prevalence of, the incidence of and the risk factors for peri-implant diseases and of experimental clinical studies evaluating the efficacy of preventive and therapeutic interventions.

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Author and article information

Journal

Title: Clinical Implant Dentistry and Related Research

Abbreviated Title: Clinical Implant Dentistry and Related Research

Publisher: Wiley

ISSN: 15230899

Publication date Created: April 2017

Publication date (Print): April 2017

Publication date (Electronic): November 15 2016

Volume: 19

Issue: 2

Pages: 372-399

Affiliations

[1 ]Specialist in training, Master student Periodontology, Department Periodontology & Oral Implantology, Dental School; Faculty Medicine and Health Sciences, Ghent University Belgium

[2 ]PhD student, Department Periodontology & Oral Implantology, Dental School, Faculty Medicine and Health Sciences; Ghent University Belgium

[3 ]full professor and chairman, Department Periodontology & Oral Implantology, Dental School, Faculty Medicine and Health Sciences, Ghent University Belgium, visiting professor, Department of Prosthodontics; Malmö University, Sweden

[4 ]adjunct professor, Department of Prosthodontics; Malmö University, Sweden

[5 ]professor, Department Periodontology & Oral Implantology, Dental School, Faculty Medicine and Health Sciences, Ghent University Belgium, professor, Faculty of Medicine and Health Sciences, Oral Health Research Group ORHE, Faculty of Medicine and Pharmacy; Vrije Universiteit Brussel; Brussels Belgium

[6 ]assistant professor, Department Periodontology & Oral Implantology, Dental School, Faculty Medicine and Health Sciences; Ghent University Belgium

[7 ]professor, Faculty of Medicine and Pharmacy, Department of Educational Sciences EDWE-LOCI, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium, professor, Faculty of Medicine and Health Sciences, Oral Health Research Group ORHE, Faculty of Medicine and Pharmacy; Vrije Universiteit Brussel, Brussels, Belgium