Articulo

Marc Quirynen Marc De Soete Daniel van Steenberghe*

Review article

Infectious risks for oral implants: a review of the literature

Authors’ affiliation: Marc Quirynen, Marc De Soete, Daniel van Steenberghe, Catholic University of Leuven, Faculty of Medicine, Research Group for Microbial Adhesion, Department of Periodontology, School of Dentistry, Oral Pathology & Maxillo-facial Surgery,Leuven, Belgium * Holder of the P. I. Brånemark chair for Osseointegration Correspondence to: Professor M. Quirynen, Department of Periodontology Catholic University Leuven Kapucijnenvoer 33 B-3000 Leuven Belgium Tel: π32 16 33 24 07 Fax: π32 16 33 24 84 e-mail: Marc.Quirynen/med.kuleuven.ac.be

Key words: biofilm, dental plaque, implant therapy, dental implant, microbiology, oral implants,osseointegration, partial edentulism, periodontal disease, periodontal parameters, peri-implantitis, peri-mucositis, prevention, review, surface characteristics, susceptibility, microbial transmission, translocation. Abstract: The use of oral implants in the rehabilitation of partially and fully edentulous patients is widely accepted even though failures do occur. The chance for implants to integrate canfor example be jeopardised by the intra-oral presence of bacteria and concomitant inflammatory reactions. The longevity of osseointegrated implants can be compromised by occlusal overload and/or plaque-induced peri-implantitis, depending on the implant geometry and surface characteristics. Animal studies, cross-sectional and longitudinal observations in man, as well as association studies indicatethat periimplantitis is characterised by a microbiota comparable to that of periodontitis (high proportion of anaerobic Gram-negative rods, motile organisms and spirochetes), but this does not necessarily prove a causal relationship. However, in order to prevent such a bacterial shift, the following measures can be considered: periodontal health in the remaining dentition (to prevent bacterialtranslocation), the avoidance of deepened peri-implant pockets, and the use of a relatively smooth abutment and implant surface. Finally, periodontitis enhancing factors such as smoking and poor oral hygiene also increase the risk for peri-implantitis. Whether the susceptibility for periodontitis is related to that for peri-implantitis may vary according to the implant type and especially itssurface topography.

Date:

Accepted 22 January 2001
To cite this article:

Quirynen M, De Soete M, van Steenberghe D. Infectious risks for oral implants: a review of the literature Clin. Oral Impl. Res. 13, 2002; 1–19 Copyright C Munksgaard 2002 ISSN 0905-7161

The high clinical success rate of some implant designs in (partially) edentulous patients, as demonstrated in well-designed long-termprospective studies, has led to the widespread acceptance and use of oral implants (for review see van Steenberghe et al. 1999). Besides a number of patient-related factors such as smoking (Bain & Moy 1993), bone quality (Jaffin & Berman 1991; Hutton et al. 1995), systemic diseases or chemotherapy, surgical trauma or bacterial contamination during implant surgery are factors associated with earlyfailures (impaired healing, i.e. during the healing

phase and thus before loading). Overload (defined as a situation in which the functional load applied to the implants exceeds the capacity of the bone-implant interface to withstand it) is another important cause of early implant failure, once the prosthesis is installed. Factors associated with late failures of implants are less well understoodand seem to be related to both the peri-implant environment and host parameters. Lesions similar to those associated with teeth, such as peri-implantitis, gingival hyperplasia, fistulae and bone loss, are related to microbial plaque accumulation. The pres-

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Quirynen et al . Infectious risks for oral implants: a review

ent review will focus on peri-implantitis and the microbial factors...