Mukositis und Periimplantitis an Implantaten mit maschinell glatten und rauen Oberflächen bei Patienten mit parodontalen Erkrankungen.

Objective: The aim of the present long-term clinical and radiological study in patients with treated aggressive and chronic periodontitis is the comparison between implants with mechanically smooth and rough surfaces with regard to the prevalence of mucositis and periimplantitis. Furthermore, the influence of potential risk factors on the long-term success of the implants should be examined. Material & method: A total of 55 patients with 197 implants and 906 teeth were selected for the study. Generalized chronic periodontitis was previously diagnosed in 33 patients. 22 patients had the criteria of generalized aggressive periodontitis. 84 mechanically smooth implants were inserted into 29 patients between 1991 and 2005. Between 2006 and 2012, 113 implants with a rough surface were inserted into 26 patients. All patients underwent periodontal treatment prior to implantation. After the implantation and restoration with a superstructure, the integration into a close-knit recall program took place at intervals of 3-6 months over an examination period of up to 10 years. In addition, radiological diagnostics were carried out for the integration of the superstructure and at intervals of one, three, five and ten years. Results: The survival rate of the implants after 10 years was 98.98 % (mechanically smooth = 98.81 %, rough = 99.12 %). The survival rate of the teeth was 93.05 %. Periimplant mucositis occurred during the observation period in 15.4 % of the implants with a rough surface and in 7.0 % for implants with a mechanically smooth surface. Significance (p = 0.005) for the rough surface was demonstrated for the 5th year. The evaluation of all patients was able to evaluate a significant connection with the occurrence of periimplant mucositis for the male (p = 0.006), an increasing implant length (p = 0.001) and the implant location in the anterior jaw area (p = 0.006). The occurrence of periimplantitis was demonstrated with a slightly increased risk for implants with a rough surface (2.6 %) compared to implants with a mechanically smooth surface (0.5 %). A significant correlation with regard to the occurrence of periimplantitis in combination with a rough implant surface was found for the entire observation period (p1 = 0.038; p2 = 0.004; p3 = 0.044).The bone loss after the first year was 1.049 mm for the mechanically smooth implants compared to 1.171 mm for the implants with a rough surface. Over the entire observation period, the average bone loss per year was 0.107 mm for mechanically smooth implants and 0.089 mm for the rough implants, a significant difference between the two groups was not demonstrated. Conclusion: In summary, the present result shows that prosthetic treatment with implants as part of a strict recall program in patients with treated generalized aggressive or chronic periodontitis can be successful with both machine-smooth and rough implants. The mechanically smooth implant surfaces proved to be slightly advantageous with regard to the occurrence of peri-implant mucositis and peri-implantitis. No significance could be demonstrated regarding the type of periodontal disease and the occurrence of peri-implant inflammation.