The influence of plaque and/or overloading on the tissues surrounding Brånemark implants : a review of the literature and clinical experience

Aim of the study

This article attempts, with an extensive bibliography and long term studies, to determine if peri-implant marginal bone loss can be associated with prolonged overloading and/or gingivitis.

Results

Radiographic examination of the marginal bone and the probing of pockets is used to assess bone levels and peri-implant attachment. The use of a probe is preferred when follow up assessments are frequent, in the knowledge that the end of the probe reaches 1 to 2 mm short of the marginal bone.

In patients presenting with aggressive periodontitis, the marginal bone around Brånemark implants seems to be more resistant to attachment loss than around the neighbouring teeth. If the maxilla are very resorbed, implants in dense and good quality bone have better resistance to occlusal overload. The same is true for long implants in the maxilla in cases where there is little resorption and dense bone.

Conclusion

The maintenance of a stable level of marginal bone is still a challenge. Bone loss can compromise the stability of the implant. The choice of implant system used, plaque control, and the reduction of occlusal overload remain the key strategies for success.

Commentary

This article, by way of the extent of its bibliography and its long term nature, presents the effects of various factors on the survival of implants. It is important, as has been emphasised by the authors, to have uniformity in the statistical results presented ; the necessity for cumulative success rates, such as survival tables for all systems.