Premium
Peri‐implantitis prevalence, incidence rate, and risk factors: A study of electronic health records at a U.S. dental school
Author(s) -
Kordbacheh Changi Khashayar,
Finkelstein Joseph,
Papapanou Panos N.
Publication year - 2019
Publication title -
clinical oral implants research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.407
H-Index - 161
eISSN - 1600-0501
pISSN - 0905-7161
DOI - 10.1111/clr.13416
Subject(s) - peri implantitis , dentistry , medicine , incidence (geometry) , surgery , implant , mathematics , geometry
Objectives We assessed peri‐implantitis prevalence, incidence rate, and associated risk factors by analyzing electronic oral health records (EHRs) in an educational institution. Methods We used a validated reference cohort comprising all patients receiving dental implants over a 3.5‐year period (2,127 patients and 6,129 implants). Electronic oral health records of a random 10% subset were examined for an additional follow‐up of ≥2.5 years to assess the presence of radiographic bone loss, defined as >2 mm longitudinal increase in the distance between the implant shoulder and the supporting peri‐implant bone level (PBL) between time of placement and follow‐up. “Intact” implants had no or ≤2 mm PBL increase from baseline. Electronic oral health record notes were reviewed to corroborate a definitive peri‐implantitis diagnosis at implants with progressive bone loss. A nested case–control analysis of peri‐implantitis‐affected implants randomly matched by age with “intact” implants from peri‐implantitis‐free individuals identified putative risk factors. Results The prevalence of peri‐implantitis over an average follow‐up of 2 years was 34% on the patient level and 21% on the implant level. Corresponding incidence rates were 0.16 and 0.10 per patient‐year and implant‐year, respectively. Multiple conditional logistic regression identified ill‐fitting fixed prosthesis (OR = 5.9; 95% CI: 1.6–21.1), cement‐retained prosthesis (OR = 4.5; 2.1–9.5), and radiographic evidence of periodontitis (OR = 3.6; 1.7–7.6) as statistically associated with peri‐implantitis. Implant location in the mandible (OR = 0.02; 0.003–0.2) and use of antibiotics in conjunction with implant surgery (OR = 0.19; 0.05–0.7) emerged as protective exposures. Conclusions Approximately 1/3 of the patients and 1/5 of all implants experienced peri‐implantitis. Ill‐fitting/ill‐designed fixed and cement‐retained restorations, and history of periodontitis emerged as the principal risk factors for peri‐implantitis.