By Ismael Khouly DDS, MS, PhD
The Academy of Osseointegration (AO)’s Young Clinician Committee is challenging all researchers and clinicians in implant dentistry to sharpen their focus toward more pronounced identification and validation of risk factors for peri-implant disease (PID) and implant failure, which can result in improved outcomes for patients.
More than 3 million dental implants are placed each year in the United States and the number of procedures is estimated to increase by 500,000 annually. Older patients drive most of the demand for dental implants, as well as those having systemic conditions such as diabetes, smoke and also have periodontal disease.
PID is one of the major challenges in modern implant dentistry despite high initial implant survival and success rates. Indeed, PID is rapidly becoming an epidemic, with up to 80 percent of patients receiving dental implants eventually developing peri-implant complications. PID includes progressive, chronic infections of the soft and hard tissues surrounding the dental implant. While some of these lesions are minor, up to half of all implant patients may develop peri-implantitis, a form of PID, putting them at risk for implant loss.
We can take steps to improve evaluation of PID in patients before it becomes troublesome. Evaluating the relative contributions of novel indicators, including risk factors, may allow clinicians to more accurately predict patient outcomes and adjust therapeutic procedures at a more personalized level.
For example, understanding the pro-inflammatory factors associated with chronic conditions, including diabetes mellitus, may have implications for PID progression and failure. Furthermore, the analysis of risk factors may also be used as a “tool for the early diagnosis and/or determination of patient susceptibility” for PID and implant failure.
Knowledge gleaned from future studies may allow clinicians to tailor implant treatment to a patient’s known risks. Moreover, a preventative treatment can be employed in patients who are most susceptible to implant complications and who are thus most likely to benefit.