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Clinical Oral Investigations

Published in:

01-07-2017 | Original Article

Premature exposure of dental implant cover screws. A retrospective evaluation of risk factors and influence on marginal peri-implant bone level changes

Authors: Moritz Hertel, Yun-Chie Roh, Konrad Neumann, Frank Peter Strietzel

Published in: Clinical Oral Investigations | Issue 6/2017

Abstract

Objectives

The objectives of this study were to identify risk factors associated with the premature cover screw exposure (pCSE) at dental implants and to evaluate the influence of a pCSE on peri-implant marginal bone level (MBL) change compared to non-exposed implants.

Materials and methods

Retrospective data assessment from 165 patients (mean age = 54.0 ± 14.4 years) who received 395 submerged implants included demographic, health-related, and therapeutic variables which were analyzed for their respective impact. MBL change was detected at digital radiographs obtained from first- and second-stage surgeries.

Results

pCSE were detected in 43 patients (26.1%) and 53 implants (13.4%). An increased frequency of exposure was significantly associated with (I) male gender (p = 0.012) at patient level and (II) the posterior region of the jaws (p = 0.005), implant systems with platform-matching cover screws, and a vertical distance of ≥0.5 mm between bone crest and the implant platform (both p < 0.001) at implant level. The decrease in mesial, distal, and total MBL differed significantly (mean total = 0.8 ± 0.7 vs. 0.3 ± 0.5; mean mesial = 0.8 ± 0.8 vs. 0.3 ± 0.6; mean distal = 0.8 ± 0.8 vs. 0.3 ± 0.6 mm; p < 0.001) between non-exposed and pCSE implants.

Conclusions

Male patients, implants with platform-matched cover screws, or when placed supracrestally or in posterior sites revealed significantly more pCSE, resulting in significantly decreased peri-implant MBL compared with non-exposed implants.

Clinical relevance

Patients with an enhanced risk of pCSE should follow frequent regular recalls during the healing period to enable for early diagnosis and intervention.

Buser D, Weber HP, Donath K, Fiorellini JP, Paquette DW, Williams RC (1992) Soft tissue reactions to non-submerged unloaded titanium implants in beagle dogs. J Periodontol 63:225–235. doi:10.1902/jop.1992.63.3.225 CrossRefPubMed

Ericsson I, Randow K, Glantz PO, Lindhe J, Nilner K (1994) Clinical and radiographical features of submerged and nonsubmerged titanium implants. Clin Oral Implants Res 5:185–189CrossRefPubMed

Abrahamsson I, Berglundh T, Moon IS, Lindhe J (1999) Peri-implant tissues at submerged and non-submerged titanium implants. J Clin Periodontol 26:600–607CrossRefPubMed

Abrahamsson I, Berglundh T, Wennstrom J, Lindhe J (1996) The peri-implant hard and soft tissues at different implant systems. A comparative study in the dog. Clin Oral Implants Res 7:212–219CrossRefPubMed

Cochran DL, Hermann JS, Schenk RK, Higginbottom FL, Buser D (1997) Biologic width around titanium implants. A histometric analysis of the implanto-gingival junction around unloaded and loaded nonsubmerged implants in the canine mandible. J Periodontol 68:186–198. doi:10.1902/jop.1997.68.2.186 CrossRefPubMed

Collaert B, De Bruyn H (1998) Comparison of Branemark fixture integration and short-term survival using one-stage or two-stage surgery in completely and partially edentulous mandibles. Clin Oral Implants Res 9:131–135CrossRefPubMed

Tal H, Dayan D (2000) Spontaneous early exposure of submerged implants: III. Histopathology of perforated mucosa covering submerged implants. J Periodontol 71:1231–1235. doi:10.1902/jop.2000.71.8.1231 CrossRefPubMed

Gould TR, Westbury L, Brunette DM (1984) Ultrastructural study of the attachment of human gingiva to titanium in vivo. J Prosthet Dent 52:418–420CrossRefPubMed

McKinney RV Jr, Steflik DE, Koth DL (1985) Evidence for a junctional epithelial attachment to ceramic dental implants. A transmission electron microscopic study. J Periodontol 56:579–591. doi:10.1902/jop.1985.56.10.579 CrossRefPubMed

10.

Tal H (1999) Spontaneous early exposure of submerged implants: I. Classification and clinical observations. J Periodontol 70:213–219. doi:10.1902/jop.1999.70.2.213 CrossRefPubMed

11.

Barboza EP, Caula AL (2002) Diagnoses, clinical classification, and proposed treatment of spontaneous early exposure of submerged implants. Implant Dent 11:331–337CrossRefPubMed

12.

Toljanic JA, Banakis ML, Willes LA, Graham L (1999) Soft tissue exposure of endosseous implants between stage I and stage II surgery as a potential indicator of early crestal bone loss. Int J Oral Maxillofac Implants 14:436–441PubMed

13.

Cehreli MC, Kokat AM, Uysal S, Akca K (2010) Spontaneous early exposure and marginal bone loss around conventionally and early-placed submerged implants: a double-blind study. Clin Oral Implants Res 21:1327–1333. doi:10.1111/j.1600-0501.2010.01952.x CrossRefPubMed

14.

Kim TH, Lee DW, Kim CK, Park KH, Moon IS (2009) Influence of early cover screw exposure on crestal bone loss around implants: intraindividual comparison of bone level at exposed and non-exposed implants. J Periodontol 80:933–939. doi:10.1902/jop.2009.080580 CrossRefPubMed

15.

Van Assche N, Collaert B, Coucke W, Quirynen M (2008) Correlation between early perforation of cover screws and marginal bone loss: a retrospective study. J Clin Periodontol 35:76–79. doi:10.1111/j.1600-051X.2007.01158.x CrossRefPubMed

16.

Adell R, Lekholm U, Rockler B, Branemark PI (1981) A 15-year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 10:387–416CrossRefPubMed

17.

Smeets R, Henningsen A, Jung O, Heiland M, Hammacher C, Stein JM (2014) Definition, etiology, prevention and treatment of peri-implantitis—a review. Head & face medicine 10:34. doi:10.1186/1746-160X-10-34 CrossRef

18.

Kazzi D, Horner K, Qualtrough AC, Martinez-Beneyto Y, Rushton VE (2007) A comparative study of three periapical radiographic techniques for endodontic working length estimation. Int Endod J 40:526–531. doi:10.1111/j.1365-2591.2007.01251.x CrossRefPubMed

19.

Forsberg J (1987) Radiographic reproduction of endodontic “working length” comparing the paralleling and the bisecting-angle techniques. Oral Surg Oral Med Oral Pathol 64:353–360CrossRefPubMed

20.

Albrektsson T, Zarb G, Worthington P, Eriksson AR (1986) The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1:11–25PubMed

21.

Lundgren D, Rylander H, Laurell L (2008) To save or to extract, that is the question. Natural teeth or dental implants in periodontitis-susceptible patients: clinical decision-making and treatment strategies exemplified with patient case presentations. Periodontol 47:27–50. doi:10.1111/j.1600-0757.2007.00239.x CrossRef

22.

Papaspyridakos P, Chen CJ, Singh M, Weber HP, Gallucci GO (2012) Success criteria in implant dentistry: a systematic review. J Dent Res 91:242–248. doi:10.1177/0022034511431252 CrossRefPubMed

23.

Oh TJ, Yoon J, Misch CE, Wang HL (2002) The causes of early implant bone loss: myth or science? J Periodontol 73:322–333. doi:10.1902/jop.2002.73.3.322 CrossRefPubMed

24.

Albrektsson T, Buser D, Sennerby L (2012) On crestal/marginal bone loss around dental implants. Int J Prosthodont 25:320–322PubMed

25.

Strietzel FP, Neumann K, Hertel M (2015) Impact of platform switching on marginal peri-implant bone-level changes. A systematic review and meta-analysis. Clin Oral Implants Res 26:342–358. doi:10.1111/clr.12339 CrossRefPubMed

26.

Strietzel FP, Reichart PA (2007) Oral rehabilitation using Camlog screw-cylinder implants with a particle-blasted and acid-etched microstructured surface. Results from a prospective study with special consideration of short implants. Clin Oral Implants Res 18:591–600. doi:10.1111/j.1600-0501.2007.01375.x CrossRefPubMed

27.

Bezerra Ferreira JD, Rodrigues JA, Piattelli A, Iezzi G, Gehrke SA, Shibli JA (2015) The effect of cigarette smoking on early osseointegration of dental implants: a prospective controlled study. Clin Oral Implants Res. doi:10.1111/clr.12705 PubMed

28.

Cassetta M, Pranno N, Calasso S, Di Mambro A, Giansanti M (2015) Early peri-implant bone loss: a prospective cohort study. Int J Oral Maxillofac Surg 44:1138–1145. doi:10.1016/j.ijom.2015.04.002 CrossRefPubMed

29.

Schwartz-Arad D, Samet N, Samet N, Mamlider A (2002) Smoking and complications of endosseous dental implants. J Periodontol 73:153–157. doi:10.1902/jop.2002.73.2.153 CrossRefPubMed

30.

Clementini M, Rossetti PH, Penarrocha D, Micarelli C, Bonachela WC, Canullo L (2014) Systemic risk factors for peri-implant bone loss: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 43:323–334. doi:10.1016/j.ijom.2013.11.012 CrossRefPubMed

31.

Strietzel FP, Reichart PA, Kale A, Kulkarni M, Wegner B, Kuchler I (2007) Smoking interferes with the prognosis of dental implant treatment: a systematic review and meta-analysis. J Clin Periodontol 34:523–544. doi:10.1111/j.1600-051X.2007.01083.x CrossRefPubMed

32.

McDermott NE, Chuang SK, Woo VV, Dodson TB (2003) Complications of dental implants: identification, frequency, and associated risk factors. Int J Oral Maxillofac Implants 18:848–855PubMed

33.

Feloutzis A, Lang NP, Tonetti MS, Burgin W, Bragger U, Buser D, Duff GW, Kornman KS (2003) IL-1 gene polymorphism and smoking as risk factors for peri-implant bone loss in a well-maintained population. Clin Oral Implants Res 14:10–17CrossRefPubMed

34.

Heitz-Mayfield LJ, Huynh-Ba G (2009) History of treated periodontitis and smoking as risks for implant therapy. Int J Oral Maxillofac Implants 24(Suppl):39–68PubMed

35.

Feitosa Dda S, Bezerra Bde B, Ambrosano GM, Nociti FH, Casati MZ, Sallum EA, de Toledo S (2008) Thyroid hormones may influence cortical bone healing around titanium implants: a histometric study in rats. J Periodontol 79:881–887. doi:10.1902/jop.2008.070466 CrossRefPubMed

36.

Attard NJ, Zarb GA (2002) A study of dental implants in medically treated hypothyroid patients. Clin Implant Dent Relat Res 4:220–231CrossRefPubMed

37.

Chrcanovic BR, Albrektsson T, Wennerberg A (2014) Diabetes and oral implant failure: a systematic review. J Dent Res 93:859–867. doi:10.1177/0022034514538820 CrossRefPubMedPubMedCentral

38.

Roccuzzo M, Grasso G, Dalmasso P (2015) Keratinized mucosa around implants in partially edentulous posterior mandible: 10-year results of a prospective comparative study. Clin Oral Implants Res. doi:10.1111/clr.12563 PubMed

Title: Premature exposure of dental implant cover screws. A retrospective evaluation of risk factors and influence on marginal peri-implant bone level changes
Authors: Moritz Hertel
Yun-Chie Roh
Konrad Neumann
Frank Peter Strietzel
Publication date: 01-07-2017
Publisher: Springer Berlin Heidelberg
Published in: Clinical Oral Investigations / Issue 6/2017
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-016-2001-2

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Premature exposure of dental implant cover screws. A retrospective evaluation of risk factors and influence on marginal peri-implant bone level changes

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusions

Clinical relevance

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