Abstract
Peri-implant infections jeopardize long-term survival and success of dental implants. Because the number of implants placed in everyday clinical practice is continuously increasing, it is reasonable to anticipate an increasing prevalence of peri-implant infections. This underlines the necessity for scientifically based clinical guidelines for prevention and treatment. The aim of this thesis was to investigate epidemiological and microbiological aspects of peri-implant infections and to evaluate the effects of various protocols for treatment of peri-implantitis.
It was shown that peri-implantitis is not very likely to occur within the first five years of implant functioning, but it is frequently observed after this period. Higher prevalence is reported for smokers and patients with a history of periodontitis. Several bacteria that are associated with periodontitis are also associated with peri-implantitis. Extraction of periodontally compromised teeth seems to reduce these bacteria in the mouth and might limit the colonization of newly-placed dental implants with these potentially virulent bacteria.
Rinsing of the implant surface with chlorhexidine, in addition to mechanical implant surface debridement, does not enhance clinical outcomes of surgical peri-implantitis treatment. However, other factors such as experience of the surgical team, severity of the disease and behavioral patient factors (smoking, oral hygiene) do seem to influence the treatment outcomes.
Overall, it seems that it is difficult to treat peri-implantitis successfully, even when using a surgical treatment approach. This, combined with the notion that peri-implantitis seems to develop and progress relatively fast, stresses the importance of disease prevention.
It was shown that peri-implantitis is not very likely to occur within the first five years of implant functioning, but it is frequently observed after this period. Higher prevalence is reported for smokers and patients with a history of periodontitis. Several bacteria that are associated with periodontitis are also associated with peri-implantitis. Extraction of periodontally compromised teeth seems to reduce these bacteria in the mouth and might limit the colonization of newly-placed dental implants with these potentially virulent bacteria.
Rinsing of the implant surface with chlorhexidine, in addition to mechanical implant surface debridement, does not enhance clinical outcomes of surgical peri-implantitis treatment. However, other factors such as experience of the surgical team, severity of the disease and behavioral patient factors (smoking, oral hygiene) do seem to influence the treatment outcomes.
Overall, it seems that it is difficult to treat peri-implantitis successfully, even when using a surgical treatment approach. This, combined with the notion that peri-implantitis seems to develop and progress relatively fast, stresses the importance of disease prevention.
Original language | English |
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Qualification | Doctor of Philosophy |
Awarding Institution |
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Supervisors/Advisors |
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Award date | 21-Oct-2015 |
Place of Publication | [Groningen] |
Publisher | |
Print ISBNs | 978-90-367-8136-7 |
Electronic ISBNs | 978-90-367-8135-0 |
Publication status | Published - 2015 |