Effectiveness of Implant Therapy Analyzed in a Swedish Population: Prevalence of Peri-implantitis – EDITORIAL by Emil L.A. Svoboda

Intro:

I have been placing and restoring dental implants for over 25 years and was intrigued by an article by J. Derks et al. “Effectiveness of Implant Therapy Analyzed in a Swedish Population: Prevalence of Peri-implantitis” JDR January 1, 2016 95: 43-49.  A copy of this article was sent to all dentists in Ontario, Canada by the Royal College of Dental Surgeons of Ontario (RCDSO). I have some serious reservations regarding the potential interpretation of the results from this article.

1. J Derks et al. acknowledges the large variation in the literature regarding the criteria used to diagnose mucositis and peri-implantitis. Their selection of criteria used for the diagnosis of peri-implant disease may mislead the reader to a biased conclusion of an Exaggerated Prevalence of Peri-implant Disease.
2. When I look at the post treatment care received by the 9 year group of implant patients studied, I suggest that the results of their study describe “What can happen to a group of heavily restored implant patients when they receive Inappropriate Professional Care”.

Exaggerated Prevalence of Peri-implant disease

It is true that there is a lot of variation in the criteria used to diagnose peri-implant disease in previous publications. This variation is probably due to the fact that the diagnostic tests used to diagnose gingivitis and periodontitis around natural teeth has been applied to dental implants.  Dental Implants are not teeth. We know that the gingival tissues do not connect to dental implants in the same way as it does to natural teeth. Dental implants are frequently surrounded by cuffs of soft tissue covered with a fragile thin layer of epithelium adjacent to the dental implant. Probing of this epithelium  can easily make it bleed. This bleeding may not be a sign of pathology, but a sign of injury…