Email Alert | RSS

Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (1): 136-144. doi: 10.19723/j.issn.1671-167X.2019.01.024

Previous Articles     Next Articles

Oral hygiene maintenance of locator attachments implant overdentures in edentulous population: A longitudinal study

Xiao-qian LIU1,Qiu-wen CHEN1,Hai-lan FENG1,Bing WANG2,Jian QU2,Zhen SUN2,Mo-di HENG2,Shao-xia PAN1,△()   

  1. 1. Department of Prosthodontics, Beijing 100081, China
    2. Department Laboratory, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2018-10-08 Online:2019-02-18 Published:2019-02-26
  • Contact: Shao-xia PAN E-mail:panshaoxia@vip.163.com
  • Supported by:
    Supported by the Program for New Clinical Techniques Therapies of Peking University and School and Hospital of Stomatology(PKUSSNCT-09B20);and the Scientific Research Foundation for Returned Overseas Chie Scholars, States Education Ministry(2012-940)

RICH HTML

   

PDF (PC)

Abstract:

Objective: To investigate the oral hygiene status of edentulous patients with locator attachments implant overdentures (IOD) and to analyze the relationship among daily hygiene behavior, oral hygiene status and peri-implant diseases. Methods: Edentulous patients who received IOD treatment with locator attachments from January 2012 to May 2016 were recruited. Clinical and radiographic examinations were conducted to assess the peri-implant tissue status. Modified plaque index (mPLI), sulcus bleeding index (SBI), gingival index (GI), and probing depth (PD) were recorded and peri-implant marginal bone loss (MBL) was measured using paralleling projection technique. Patients’ peri-implant oral hygiene maintainence habits were investigated. The correlation between peri-implant diseases and oral hygiene status and behaviors was analyzed. Results: Fifty patients (125 implants) with an average follow-up time of 22 months (6-54 months) were enrolled. The mean values of mPLI, SBI, and GI were 1.4±1.2, 0.8±0.7, and 0.7±0.6, respectively. Average PD was (2.2±0.7) mm. Mesial and distal maginal bone resorptions were (1.1±1.1) mm and (0.9±0.9) mm, respectively. The prevalance of mucositis and peri-implantitis of the implants were 49.6% and 0. The prevelance of mucositis in the patients with poor oral hygiene (mPLI≥2) was 11.9 times as much as that of those with adequate oral hygiene (mPLI<1). The patients who performed oral hygiene procedure on attachments at least twice a day achieved much lower mPLI scores than those who cleaned less than twice a day. Conclusion: Oral hygiene condition in the group of patients with implant overdentures was poor, and it contributed to increased risk of peri-implant mucositis. The prevelance of musositis of the paitients with poor oral hygiene was 11.9 times as much as that of those with proper oral hygiene. Patients wearing IOD should pay more attention to the hygiene of the attachments.

Key words: Edentulous jaw, Dental implants, Locator attachments, Oral hygiene

CLC Number: 

  • R783.4

Table 1

Fully and partially edentulous in 50 paitients"

Diagnosis n (%)
Edentulous mandible and maxila 24 (48)
Partially edentulous maxilla and edentulous mandible 17 (34)
Partially edentulous maxilla and mandible 1 (2)
Complete dentition of maxilla and edentulous mandible 8 (16)
Total 50 (100)

Table 2

Scores of cinical indicators for 125 implants"

Clinical indicators Mean±standard deviation
Modified plaque index 1.4±1.2
Sulcus bleeding index 0.8±0.7
Gingival index 0.7±0.6
Probing depth/mm 2.2±0.7
Buccal keratinized mucosa index/mm 3.2±1.4
Lingual keratinized mucosa index/mm 2.1±1.2

Figure 1

Plaque accumulation on the attachments"

Table 3

Modified plaque index for different age groups"

Age group Modified plaque index (x?±s)
<60 years old (n=11) 1.2±1.2
60-70 years old (n=22) 1.4±1.1
70-80 years old (n=13) 1.4±1.0
≥ 80 years old (n=4) 2.3±0.5

Figure 2

The per-implant mucositis"

Table 4

Classification of the independent variables and the occurrence of per-implant mucositis and peri-implantitis around the corresponding implants"

Factors Number of implants Healthy mucosa Per-implant mucositis Peri-implantitis
Main cause of tooth loss
Periodontitis
Non-periodontitis
86
39
39 (45.3%)
24 (61.5%)
47 (54.7%)
15 (38.5%)
0
0
Jaw grouping
Full edentulous jaw
Non-full edentulous jaw
70
55
40 (57.1%)
23 (41.8%)
30 (42.9%)
32 (58.2%)
0
0
mPLI grouping
Bad
General
Good
37
32
56
3 (8.1%)*
8 (25.0%)
52 (92.9%)
34 (81.9%)*
24 (75.0%)
4 (7.1%)
0
0
0
Follow-up time after restoring
Above 48 months
36-48 months
24-36 months
12-24 months
6-12 months
4
4
23
55
39
0 (0)
2 (50.0%)
17 (73.9%)
19 (34.5%)#
25 (56.8%)
4 (100.0%)
2 (50.0%)
6 (26.1%)
36 (65.4%)
14 (43.2%)
0
0
0
0
0
Brand of the implant
Straumann
Bego
65
60
25 (38.5%)
38 (63.3%)
40 (61.5%)
22 (36.7%)
0
0
Implant level
Bone level
Soft tissue level
82
43
46 (56.1%)
17 (39.5%)
36 (43.9%)
26 (60.5%)
0
0
Smoking
Yes
No
12
113
1 (8.3%)△
62 (54.9%)
11 (91.7%)△
51 (45.1%)
0
0
Diabetes
Yes
No
12
113
5 (41.7%)
58 (51.3%)
7 (58.3%)
55 (48.7%)
0
0

Figure 3

Comparison of mPLI, SBI, and GI scores of patients with different cleaning behaviors of attachments * P<0.05."

[1] Lindhe J, Meyle J . Peri-implant diseases: Consensus report of the sixth European Workshop on periodontology[J]. J Clin Periodontol, 2008,35(8 Suppl):282-285.
doi: 10.1111/j.1600-051X.2008.01278.x pmid: 18724855
[2] Heitz-Mayfield LJ . Peri-implant diseases: diagnosis and risk indicators[J]. J Clin Periodontol, 2008,35(8 Suppl):292-304.
doi: 10.1111/j.1600-051X.2008.01275.x pmid: 18724857
[3] Laine ML, Leonhardt A, Roos-Jansåker AM , et al. IL-1RN gene polymorphism is associated with peri-implantitis[J]. Clin Oral Implants Res, 2006,17(4):380-385.
doi: 10.1111/j.1600-0501.2006.01249.x pmid: 16907768
[4] Heitz-Mayfield LJ . Disease progression: identification of high-risk groups and individuals for periodontitis[J]. J Clin Periodontol, 2005,32(Suppl 6):196-209.
doi: 10.1111/j.1600-051X.2005.00803.x pmid: 16128838
[5] Ericsson I, Berglundh T, Marinello C , et al. Long-standing plaque and gingivitis at implants and teeth in the dog[J]. Clin Oral Implants Res, 1992,3(3):99-103.
doi: 10.1034/j.1600-0501.1992.030301.x pmid: 1290796
[6] Pontoriero R, Tonelli MP, Carnevale G , et al. Experimentally induced peri-implant mucositis. A clinical study in humans[J]. Clin Oral Implants Res, 1994,5(4):254-259.
doi: 10.1034/j.1600-0501.1994.050409.x pmid: 7640340
[7] Salvi GE, Aglietta M, Eick S , et al. Reversibility of experimental peri-implant mucositis compared with experimental gingivitis in humans[J]. Clin Oral Implants Res, 2012,23(2):182-190.
doi: 10.1111/j.1600-0501.2011.02220.x pmid: 21806683
[8] Salvi GE, Ramseier CA . Efficacy of patient-administered mecha-nical and/or chemical plaque control protocols in the management of peri-implant mucositis. A systematic review[J]. J Clin Perio-dontol, 2015,42(Suppl 16):S187-S201.
doi: 10.1111/jcpe.12321 pmid: 25495416
[9] Todescan S, Lavigne S, Kelekis-Cholakis A . Guidance for the maintenance care of dental implants: clinical review[J]. J Can Dent Assoc, 2012,78:c107.
doi: 10.1111/j.1752-7325.2011.00311.x pmid: 23306040
[10] Tawse-Smith A, Duncan WJ, Payne AG , et al. Relative effectiveness of powered and manual toothbrushes in elderly patients with implant-supported mandibular overdentures[J]. J Clin Periodontol, 2002,29(4):275-280.
doi: 10.1034/j.1600-051X.2002.290401.x pmid: 11966923
[11] Budtz-Jorgensen E . Prosthodontics for the elderly: Diagnosis and treatment[M]. Chicago: Quintessence, 1999.
[12] Mombelli A, van Oosten MA, Schurch EJ , et al. The microbiota associated with successful or failing osseointegrated titanium implants[J]. Oral Microbiol Immunol, 1987,2(4):145-151.
doi: 10.1111/j.1399-302X.1987.tb00298.x
[13] Loe H, Silness J . Periodontal disease in pregnancy. I. Prevalence and severity[J]. Acta Odontol Scand, 1963,21:533-551.
doi: 10.3109/00016356309011240 pmid: 14121956
[14] Renvert S, Persson GR, Pirih FQ , et al. Peri-implant health, peri-implant mucositis, and peri-implantitis: Case definitions and diagnostic considerations[J]. J Periodontol, 2018,89(Suppl 1):S304-S312.
doi: 10.1002/JPER.17-0588
[15] Meijer HJA, Raghoebar GM, Batenburg RHK , et al. Mandibular overdentures supported by two Brånemark, IMZ or ITI implants: a ten-year prospective randomized study[J]. J Clin Periodontol, 2009,36(9):799-806.
doi: 10.1111/j.1600-051X.2009.01442.x
[16] Elsyad MA, Elsaih EA, Khairallah AS . Marginal bone resorption around immediate and delayed loaded implants supporting a locator-retained mandibular overdenture. A 1-year randomised controlled trial[J]. J Oral Rehabil, 2014,41(8):608-618.
doi: 10.1111/joor.12182 pmid: 24814408
[17] di Torresanto VM, Milinkovic I, Torsello F , et al. Computer-assisted flapless implant surgery in edentulous elderly patients: a 2-year follow up[J]. Quintessence Int, 2014,45(5):419-429.
doi: 10.3290/j.qi.a31534 pmid: 24634906
[18] 胡秀莲, 罗佳, 李健慧 , 等. 无牙颌种植修复患者127例临床回顾研究[J]. 中华口腔医学杂志, 2014,49(6):333-338.
doi: 10.3760/cma.j.issn.1002-0098.2014.06.004
[19] Meijer HJ, Raghoebar GM, de Waal YC ,et al. Incidence of peri-implant mucositis and peri-implantitis in edentulous patients with an implant-retained mandibular overdenture during a 10-year follow-up period[J]. J Clin Periodontol, 2014,41(12):1178-1183.
doi: 10.1111/jcpe.12311 pmid: 25229397
[20] Roos-Jansaker AM, Renvert H, Lindahl C , et al. Nine- to fourteen-year follow-up of implant treatment. Part Ⅲ: factors associated with peri-implant lesions[J]. J Clin Periodontol, 2006,33(4):296-301.
doi: 10.1111/cpe.2006.33.issue-4
[21] Ferreira SD, Silva GL, Cortelli JR , et al. Prevalence and risk variables for peri-implant disease in Brazilian subjects[J]. J Clin Periodontol, 2006,33(12):929-935.
doi: 10.1111/cpe.2006.33.issue-12
[22] Zitzmann NU, Berglundh T, Marinello CP , et al. Experimental peri-implant mucositis in man[J]. J Clin Periodontol, 2001,28(6):517-523.
doi: 10.1034/j.1600-051x.2001.028006517.x pmid: 11350518
[23] Costa FO, Takenaka-Martinez S, Cota LO , et al. Peri-implant disease in subjects with and without preventive maintenance: a 5-year follow-up[J]. J Clin Periodontol, 2012,39(2):173-181.
doi: 10.1111/j.1600-051X.2011.01819.x pmid: 22111654
[24] Ogata Y, Nakayama Y, Tatsumi J , et al. Prevalence and risk factors for peri-implant diseases in Japanese adult dental patients[J]. J Oral Sci, 2016,59(1):1-11.
doi: 10.2334/josnusd.16-0027 pmid: 27725369
[25] D’Hoedt B, Schulte W . A comparative study of results with various endosseous implant systems[J]. Int J Oral Maxillofac Implants, 1989,4(2):95-105.
pmid: 2599587
[26] Versteegh PA, van Beek GJ, Slagter AP , et al. Clinical evaluation of mandibular overdentures supported by multiple-bar fabrication: a follow-up study of two implant systems[J]. Int J Oral Maxillofac Implants, 1995,10(5):595-603.
pmid: 7591005
[27] Kirsch A, Mentag PJ . The IMZ endosseous two phase implant system: a complete oral rehabilitation treatment concept[J]. J Oral Implantol, 1986,12(4):576-589.
pmid: 3540314
[28] Smith DE, Zarb GA . Criteria for success of osseointegrated endosseous implants[J]. J Prosthet Dent, 1989,62(5):567-572.
doi: 10.1016/0022-3913(89)90081-4 pmid: 2691661
[29] Esposito M, Hirsch JM, Lekholm U , et al. Biological factors contributing to failures of osseointegrated oral implants. (II). Etiopathogenesis[J]. Eur J Oral Sci, 1998,106(3):721-764.
doi: 10.1046/j.0909-8836..t01-6-.x
[30] Pjetursson BE, Helbling C, Weber HP , et al. Peri-implantitis susceptibility as it relates to periodontal therapy and supportive care[J]. Clin Oral Implants Res, 2012,23(7):888-894.
doi: 10.1111/j.1600-0501.2012.02474.x pmid: 22530771
[31] Cho-Yan LJ, Mattheos N, Nixon KC , et al. Residual periodontal pockets are a risk indicator for peri-implantitis in patients treated for periodontitis[J]. Clin Oral Implants Res, 2012,23(3):325-333.
doi: 10.1111/j.1600-0501.2011.02264.x pmid: 22020202202020220
[32] Karoussis IK, Salvi GE, Heitz-Mayfield LJ , et al. Long-term implant prognosis in patients with and without a history of chronic periodontitis: a 10-year prospective cohort study of the ITI Dental Implant System[J]. Clin Oral Implants Res, 2003,14(3):329-339.
doi: 10.1034/j.1600-0501.000.00934.x
[33] Mombelli A, Marxer M, Gaberthuel T , et al. The microbiota of osseointegrated implants in patients with a history of periodontal disease[J]. J Clin Periodontol, 1995,22(2):124-130.
doi: 10.1111/j.1600-051X.1995.tb00123.x pmid: 7775668
[34] 张海东, 孟焕新 . 牙周状况及牙周治疗对口腔种植修复长期效果的影响[J]. 中华口腔医学杂志, 2013,48(4):229-232.
doi: 10.3760/cma.j.issn.1002-0098.2013.04.009
[35] Quirynen M, van Assche N . Microbial changes after full-mouth tooth extraction, followed by 2-stage implant placement[J]. J Clin Periodontol, 2011,38(6):581-589.
doi: 10.1111/j.1600-051X.2011.01728.x pmid: 21488934
[36] Teughels W, van Eldere J, van Steenberghe D , et al. Influence of nicotine and cotinine on epithelial colonization by periodontopathogens[J]. J Periodontol, 2005,76(8):1315-1322.
doi: 10.1902/jop.2005.76.8.1315 pmid: 16101364
[37] Huang R, Li M, Gregory RL . Effect of nicotine on growth and metabolism of Streptococcus mutans[J]. Eur J Oral Sci, 2012,120(4):319-325.
[38] Li M, Huang R, Zhou X , et al. Effect of nicotine on dual-species biofilms of Streptococcus mutans and Streptococcus sanguinis[J]. FEMS Microbiol Lett, 2014,350(2):125-132.
doi: 10.1111/1574-6968.12317 pmid: 24164376
[39] Barao VA, Ricomini-Filho AP, Faverani LP , et al. The role of nicotine, cotinine and caffeine on the electrochemical behavior and bacterial colonization to cp-Ti[J]. Mater Sci Eng C Mater Biol Appl, 2015,56:114-124.
doi: 10.1016/j.msec.2015.06.026 pmid: 26249572
[40] Mombelli A, Muller N, Cionca N . The epidemiology of peri-implantitis[J]. Clin Oral Implants Res, 2012,23(Suppl 6):67-76.
doi: 10.1111/clr.12027 pmid: 23062130
[41] Vervaeke S, Collaert B, Cosyn J , et al. A multifactorial analysis to identify predictors of implant failure and peri-implant bone loss[J]. Clin Implant Dent Relat Res, 2015,17(Suppl 1):e298-e307.
doi: 10.1111/cid.12149 pmid: 24004332
[42] Strietzel FP, Reichart PA, Kale A , et al. Smoking interferes with the prognosis of dental implant treatment: a systematic review and meta-analysis[J]. J Clin Periodontol, 2007,34(6):523-544.
doi: 10.1111/j.1600-051X.2007.01083.x pmid: 17509093
[43] Zimmermann H, Zimmermann N, Hagenfeld D , et al. Is frequency of tooth brushing a risk factor for periodontitis? A systematic review and meta-analysis[J]. Community Dentistry and Oral Epidemiology, 2015,43(2):116-127.
doi: 10.1111/cdoe.12126 pmid: 25255820
[44] Elsyad MA . Patient satisfaction and prosthetic aspects with mini-implants retained mandibular overdentures. A 5-year prospective study[J]. Clin Oral Implants Res, 2016,27(7):926-933.
doi: 10.1111/clr.12660 pmid: 26129836
[45] Cordaro L, di Torresanto VM, Petricevic N , et al. Single unit attachments improve peri-implant soft tissue conditions in mandibular overdentures supported by four implants[J]. Clin Oral Implants Res, 2013,24(5):536-542.
doi: 10.1111/j.1600-0501.2012.02426.x pmid: 22320359
[46] Walton JN , MacEntee MI. Problems with prostheses on implants: a retrospective study[J]. J Prosthet Dent, 1994,71(3):283-288.
doi: 10.1016/0022-3913(94)90468-5 pmid: 8164171
[1] Congwei WANG,Min GAO,Yao YU,Wenbo ZHANG,Xin PENG. Clinical analysis of denture rehabilitation after mandibular fibula free-flap reconstruction [J]. Journal of Peking University (Health Sciences), 2024, 56(1): 66-73.
[2] Qian DING,Wen-jin LI,Feng-bo SUN,Jing-hua GU,Yuan-hua LIN,Lei ZHANG. Effects of surface treatment on the phase and fracture strength of yttria- and magnesia-stabilized zirconia implants [J]. Journal of Peking University (Health Sciences), 2023, 55(4): 721-728.
[3] Fei SUN,Jian LIU,Si-qi LI,Yi-ping WEI,Wen-jie HU,Cui WANG. Profiles and differences of submucosal microbial in peri-implantitis and health implants: A cross-sectional study [J]. Journal of Peking University (Health Sciences), 2023, 55(1): 30-37.
[4] LI Yi,YU Hua-jie,QIU Li-xin. Clinical classification and treatment decision of implant fracture [J]. Journal of Peking University (Health Sciences), 2022, 54(1): 126-133.
[5] LI Peng,PIAO Mu-zi,HU Hong-cheng,WANG Yong,ZHAO Yi-jiao,SHEN Xiao-jing. Radiography study on osteotome sinus floor elevation with placed implant simultaneously with no graft augmentation [J]. Journal of Peking University (Health Sciences), 2021, 53(1): 95-101.
[6] Zhong ZHANG,Huan-xin MENG,Jie HAN,Li ZHANG,Dong SHI. Effect of vertical soft tissue thickness on clinical manifestation of peri-implant tissue in patients with periodontitis [J]. Journal of Peking University (Health Sciences), 2020, 52(2): 332-338.
[7] Yue CAO,Jun-kai CHEN,Ke-hui DENG,Yong WANG,Yu-chun SUN,Yi-jiao ZHAO. Accuracy of three intraoral scans for primary impressions of edentulous jaws [J]. Journal of Peking University(Health Sciences), 2020, 52(1): 129-137.
[8] Chun-ping LIN,Song-he LU,Jun-xin ZHU,Hong-cheng HU,Zhao-guo YUE,Zhi-hui TANG. Influence of thread shapes of custom-made root-analogue implants on stress distribution of peri-implant bone: A three-dimensional finite element analysis [J]. Journal of Peking University(Health Sciences), 2019, 51(6): 1130-1137.
[9] Qian WANG,Dan LI,Zhi-hui TANG. Sinus floor elevation and simultaneous dental implantation: A long term retrospective study of sinus bone gain [J]. Journal of Peking University(Health Sciences), 2019, 51(5): 925-930.
[10] Zhi-yong△ ZHANG,Tian MENG,Quan CHEN,Wen-shu LIU,Yu-huan CHEN. Retrospective analysis of early dental implant failure [J]. Journal of Peking University(Health Sciences), 2018, 50(6): 1088-1091.
[11] LIU Jing-yin, CHEN Fei, GE Yan-jun, WEI Ling, PAN Shao-xia, FENG Hai-lan. Influence of implants prepared by selective laser melting on early bone healing [J]. Journal of Peking University(Health Sciences), 2018, 50(1): 117-122.
[12] WANG Jing, HE Lu. Effect of mechanical selfcleaning of tongue coating on malodor in halitosis patients originating from tongue coating [J]. Journal of Peking University(Health Sciences), 2017, 49(2): 344-348.
[13] LIANG Nai-wen, SHI Lei，HUANG Ying，DENG Xu-liang. Role of different scale structures of titanium implant in the biological behaviors of human umbilical vein endothelial cells [J]. Journal of Peking University(Health Sciences), 2017, 49(1): 43-048.
[14] LI Bei-bei, LIN Ye, CUI Hong-yan, HAO Qiang, XU Jia-bin, DI Ping. Clinical evaluation of “All-on-Four” provisional prostheses reinforced with  carbon fibers [J]. Journal of Peking University(Health Sciences), 2016, 48(1): 133-137.
[15] CUI Hong-Yan, DI Ping, LI Jian-Hui, LIN Ye, LIU Rong-Rong. Application of spark erosion technology in manufacture of implant prosthesis [J]. Journal of Peking University(Health Sciences), 2015, 47(2): 336-339.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd