Osseointegrierte Implantate bei Patienten mit behandelter generalisierter aggressiver Parodontitis und bei parodontal gesunden Patienten : 10-Jahres-Ergebnisse einer prospektiven Langzeitstudie

The aim of this prospective 10-years-study was a clinical, microbiological and radiographic comparison of the teeth and implants of patients treated for generalized aggressive periodontitis and periodontal healthy patients and assessment of the implant success rate. 5 patients treated for generalized aggressive periodontitis and 5 periodontal healthy patients participated in the study. The patients treated for generalized aggressive periodontitis recieved 35 implants while 7 implants were inserted in the group of the periodontal healthy patients. 2-4 weeks before the non-retainable teeth had been extracted a baseline examination was performed. The initial examination of the periodontally healthy residual dentition and of the unloaded implants was performed just before the insertion of the suprastructure. The examinations were continued at 3-months intervals for a total of 10 years. At each session clinical parameters which included Plaque-Index, Gingival-Index, Probing depth with bleeding on probing and clinical attachment loss were recorded. Also the composition of the subgingival microflora was determined by dark-field microscopy. Intraoral radiographs of the teeth and implants were taken at baseline and 1, 3, 5, 8 and 10 years after insertion of the suprastructure. During the whole period of examinations the Gingival-Index at the teeth and implants of the patients treated for generalized aggressive periodontitis was significant higher as the Gingival-Index of the periodontal healthy patients. The Plaque-Index showed no significant differences neither between teeth and implants nor between the 2 patient groups. The probing depths at the implants of both patient groups were comparable and showed a value of less than 4 mm all the time. The probing depths at the teeth of the patients treated for generalized aggressive periodontitis were significant higher as at the teeth of the periodontal healthy patients. A significant higher attachment loss (2,4 mm) was recorded at the implants of the patients treated for generalized aggressive periodontitis. The attachmentlevel at the teeth and the implants of the periodontal healthy patients and at the teeth of the patients treated with generalized aggressive periodontitis were almost constant. Among the microorganisms, the proportions of the cocci were lower and the proportions of the motile rods and the filaments were higher in the periodontal diseased group. The bone loss at the implants of the patients treated for generalized aggressive periodontitis was significant higher in the first year (Ø2,07 mm) and in the following 9 years (total 1,3 mm). At the teeth the bone loss was significant higher at baseline (Ø26,39%) and in the following 10 years (total 9,3%). The success rate of the implants of the periodontal healthy patients was 100%, while the success rate of the implants of the patients treated with generalized aggressive periodontitis was 82,86%. After 10 years of examinations it can be concluded that oral rehabilitation with osseointegrated implants can be successfull in partially edentulous patients treated for generalized aggressive periodontitis within the scope of an actual recall-schedule. However an increased bone loss and attachment loss could be recognized at the implants and teeth of the patients treated for generalized aggressive periodontitis.