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Peri-implantitis second most common complication following dental implant therapy

By Franziska Beier, Dental Tribune International
June 25, 2021

GOTHENBURG, Sweden: Even though high survival rates have been reported for dental implants, biological or technical complications affecting the implant, the tissue surrounding the implant, or the implant-supported reconstruction may occur, resulting in additional treatment costs. A recent study, conducted at the University of Gothenburg for a doctoral thesis, has evaluated the frequency and consequential cost of such complications.

According to the Swedish Social Insurance Agency, more than 30,000 patients receive implant-supported restorative therapy per year in Sweden. The study was based on randomly selected patients from the registry of the Social Insurance Agency and conducted by Dr Karolina Karlsson as part of her doctoral research in odontology at the University of Gothenburg. Dental records and radiographs of 2,765 adult patients were evaluated. Of these, 596 individuals were clinically examined nine years after their treatment with dental implants.

Of these 596 patients, 42% had been affected by at least one biological or technical complication during the follow-up period. Technical complications were found to be most frequent, and one-quarter of patients had experienced this type of complication. Chipping was the most common technical complication (11.0 %), followed by screw loosening (9.1%) and decementation (5.9%). Fractures of implants or abutments were observed rarely.

Karlsson determined the extent of the restorative therapy as the strongest risk indicator for technical complications.

Peri-implantitis was recorded as the second most common complication (19.0%). Treating the disease with non-surgical methods only, in the form of professional cleaning and instructions on oral hygiene, proved to be insufficient. Additional surgical treatment, however, was able to prevent further progression.

Implant loss most costly

Implant loss, which was observed in 8% of the participants, was reported to result in the highest total cost (US$2,403/€2,012) followed by combinations of different complications (US$2,347). The cost for technical complications and peri-implantitis were similar at US$1,614 and US$1,619 respectively.

Dr Karolina Karlsson . (Image: University of Gothenburg)

In a university press release, Karlsson commented on the study’s findings: “The results provide dental professionals and patients with important information, enabling them to evaluate and reduce the risk for complications associated with implant-supported restorative therapy.”

It is necessary to pay attention to risk factors for complications in the treatment planning stages. This could help prevent complications, resulting in benefits for patients. It could also save costs and, in this way, benefit society in general, stated Karlsson in her thesis.

She added that maintenance care of implant sites should be provided in order to enable the early detection of peri-implantitis and the provision of adequate treatment options. In cases of more pronounced and persistent disease, surgical interventions should be provided in order to successfully resolve the disease and prevent further progression, she emphasised.

The doctoral thesis, titled Implant-supported Restorative Therapy in a Swedish Population: Complications and Cost Evaluations, was issued in May 2021 by Sahlgrenska Academy at the University of Gothenburg.

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