DZZ International, 01/2022

Today, missing teeth can be replaced with alloplastic implants with a high probability of survival. Such restorations come close to a "restitutio ad integrum". However, the question regarding the extent to which dental implants are integrated into the existing stomatognathic control circuit remains unanswered: does the "implant as a foreign body" need to be protected in a special way, or can it be considered a "fully fledged replacement tooth" with its own sensory perception? Keywords: dental implants, osseoperception, tactile sensibility

Peri-implantitis is a plaque-associated pathological disease occurring in tissues surrounding dental implants. It is characterized by an inflamed peri-implant mucosa and resulting progressive loss of peri-implant supporting bone. Prosthodontic etiologic factors such as hygiene-incompetent prosthetic designs or residual cement seem to favor the development of peri-implantitis. During the course of the article, several characteristics of prosthetic superstructures are presented and their relevance in relation to peri-implant inflammation is discussed. Keywords: implants, peri-implantitis, prosthetic, superstructure

The use of dental implants in order to rehabilitate patients with fixed or removable implant-supported restorations has become widespread in recent decades. For example, according to the current German Oral Health Study (DMS V), patients were already 10 times more likely to be treated with implants in 2014 than in 1997. According to statistics from the American Dental Association, an estimated 5 million implants are placed annually in the USA alone. The increasing life expectancy together with the desire for fixed restorations is expected to further strengthen this trend in the future. The steadily increasing number of implants that are placed by dentists has also been accompanied by an increase in the overall number of post-implant complications. Thus, due to the increased prevalence of biological complications, relevant patient-specific risk factors must be accounted for as part of implant planning and treatment. In this sense, a synoptic treatment concept that considers the foreseeable patient-specific risk factors for peri-implant inflammation plays an important role from the pre-implant to the post-prosthetic treatment phase. The article explores the multitude of patient-specific risk factors and the various therapeutic options available as the key to long-term implant treatment success. Keywords: implants, peri-implant mucositis, peri-implantitis, risk factor, treatment

Peri-implant inflammation is still a frequent complication in dental implantology despite highly developed surgical techniques and implant components. The development of peri-implant inflammation may not only have post-implantological causes, but pre-implantological factors also play a role. In addition to the design of the prosthetic restoration, correct planning of the implant position and surgical preparation of the implant site are particularly important for the long-term success of dental implants. This paper deals with these pre-implantological factors with special emphasis on implant planning, hard and soft tissue management and navigated implant placement, taking into account current relevant literature. Keywords: hard and soft tissue management, navigated implantation, peri-implantitis, pre-implant procedure

Introduction: Peri-implantitis represents a major complication for the long-term preservation of dental implants and is often attributable to the combined effect of risk factors. This review aims to present patient-related risk factors that are linked to peri-implantitis and to discuss possible solutions in terms of a pre-implant therapy. Material and methods: While implant characteristics and surgical techniques are patient-independent risk factors for peri-implantitis, patient-related factors may also potentially contribute to an increased risk of developing peri-implantitis. The most commonly discussed factors include patient age, medication and other medical treatments, existing periodontitis, plaque and lim-ited oral hygiene, patient compliance related to supportive implant therapy, lack of attached gingiva, smoking, diet, diabetes, and patient genetics. Conclusion: Whereas patient age was not found to diminish implant survival and the factor genetics is currently considered to be unpredictable, potential influencing measures could be identified for the other risk factors. These include a comprehensive anamnesis and diagnosis, attention to contraindications (e.g. i.v. antiresorptives, patients receiving radiotherapy and smoking simultaneously), treatment of existing periodontitis, smoking cessation, adequate adjustment of HbA1c values in diabetics, dietary counseling, plaque reduction, attention to and creation of attached gingiva and sufficient hard tissue as well as offering a well-structured supportive implant therapy. Keywords: diabetes, diet, implant aftercare, peri-implantitis, plaque, pre-implant treatment, risk factors, smoking