Periimplant Disease and Prosthetic Risk Indicators: A Literature Review.

Purpose: The purpose of this review was to search in international published peer-review articles, data regarding prosthetic risk indicators affecting the incidence, prevalence, or treatment outcome of periimplant diseases.

Materials and methods: A literature search was performed in MEDLINE via PubMed database of the US National Library of Medicine of articles published until February 2018; a manual search was also added. Randomized controlled trials, controlled trials, prospective and retrospective cohort studies with a minimum of 20 subjects, having cases with/without exposure to the risk indicator were included. Articles written in another language than English were not included.

Results: The 17 articles reviewed indicated the cement residuals at abutments were identified as risk factors for both mucositis and periimplantitis. Among the screw-retained prosthetic reconstructions, prostheses screwed directly to the implants have higher risk to develop periimplant disease. The accessibility and the possibility to perform adequate plaque control around the prosthetic suprastructure decreases the risk for periimplant disease; convex emergence profiles seem to increase it. The crown margins located submucosa may impair the periimplant treatment outcome.

Conclusion: Prosthetic reconstruction on implants should be designed in a way to allow accessibility to proper plaque control. Screw-retained suprastructure and crown margins located supra-mucosa should be preferred when possible. When using cement-retained suprastructure, attention should be given to remove cement residuals.