Dreidimensionaler Knochenabbau an Implantaten bei Patienten mit generalisierter aggressiver und chronischer Parodontitis

Objectives: The aim of this prospective study of partially edentulous patients treated for generalized chronic and aggressive periodontitis was to evaluate the three-dimensional marginal bone level around implants 3-15 years after loading. Material and Methods: 17 generalized aggressive and 17 chronic periodontitis patients (GAP, GCP) with 119 implants were examined. Implants were inserted on bone level with a marginal bone thickness of at least 2 mm. The clinical examination was carried out within a framework of a 3-month recall schedule after insertion of the superstructure. For analysis of the three-dimensional bone loss and for determination of mucosa thickness, CBCT were taken once 3–15 years after insertion of the superstructure with an aligned tin-foil on the periimplant soft tissue together with a clinical examination. The Mann-Whitney-test was used for group comparison and the Spearman correlation for the relation between clinical and radiologic parameters. Statistical significance was considered p < 0.05. Results: The DVT showed in both groups most bone loss vestibular, this was more pronounced in GAP patients (4,49 ± 2,93 mm) than in GCP patients (3,57 ± 2,94 mm). In both groups, most bone loss was in the mandible (GAP: 3,03 ± 1,95 mm; GCP: 2,42 ± 0,97 mm). The thickness of the periimplant mucosa was (GAP: 1,94 ± 1,16 mm; GCP: 2,02 ± 1,14 mm) in the maxilla and (GAP: 1,02 ± 1,04 mm; GCP: 1,06 ± 0,96 mm) in the mandible. There were significant correlations between clinical parameters (implant age, bone quality, keratinized mucosa width, GR, AL, GI and PI) and bone loss in the mandible of GAP patients. Conclusions: The highest bone loss was observed vestibular in the anterior mandible. In GAP patients there was a correlation between the mucosal thickness and bone loss. Plaque-associated inflammation and the width and thickness of KM seemed to have the greatest impact on bone loss.