Suppuration as diagnostic criterium of peri-implantitis

Alberto Monje; Maria Vera; Agustín Muñoz-Sanz; Hom-Lay Wang; José Nart

doi:10.1002/JPER.20-0159

Suppuration as diagnostic criterium of peri-implantitis

J Periodontol. 2021 Feb;92(2):216-224. doi: 10.1002/JPER.20-0159. Epub 2020 Aug 21.

Authors

Alberto Monje^{1

2}, Maria Vera¹, Agustín Muñoz-Sanz³, Hom-Lay Wang¹, José Nart²

Affiliations

¹ Department of Periodontology, School of Dental Medicine, University of Michigan, Ann Arbor, Michigan, USA.
² Department of Periodontology, Universitat Internacional de Catalunya, Barcelona, Spain.
³ Division of Infectious Diseases, Department of Biomedical Sciences, Universidad de Extremadura, Badajoz, Spain.

PMID: 32729628
DOI: 10.1002/JPER.20-0159

Abstract

Background: Suppuration (SUP) as a diagnostic parameter for monitoring dental implants is not yet well understood. The retrospective clinical and radiographic study was therefore performed to investigate the patient, implant, and site characteristics among individuals exhibiting SUP.

Methods: Demographic characteristics and clinical parameters were recorded. Radiographic features were analyzed using cone-beam computed tomography. Peri-implantitis was defined based on the consensus report of Workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions: probing depth (PD) ≥6 mm, presence of bleeding and/or SUP on gentle probing, and radiographic marginal bone loss (MBL) ≥3 mm. SUP was graded according to profuseness (dot versus line/drop) and time after probing (≥15 seconds versus <15 seconds after probing versus spontaneous). Simple binary logistic regression models were estimated using generalized estimation equations to explain the probability of SUP based on demographic, clinical, and radiographic variables.

Results: A total of 111 eligible patients (n_implants = 501) were assessed. Of them, 57 (n_implants = 334) were diagnosed with peri-implantitis according to the established case definition, and of these individuals, 31 (n_implants = 96) presented SUP. Therefore, the prevalence of SUP was 27.92% in the total sample size and 54.38% in peri-implantitis patients. Overall, 28.74% implants displayed SUP within patients with peri-implantitis. SUP was more frequently found at buccal sites (51%) and proved less prevalent at mesio-lingual sites (16.7%). Defect morphology (OR = 6.59; P = 0.004), PD (OR = 1.63; P = 0.024), and MBL (OR = 1.35; P = 0.010) were significantly associated with the presence of SUP. Likewise, defect morphology (P = 0.02), PD (P = 0.003), and MBL (P = 0.01) were significantly correlated with the grade of SUP.

Conclusion: The presence and grade of SUP are associated with peri-implant bone loss, probing depth, and defect morphology in patients with peri-implantitis.

Keywords: dental implants; dental prosthesis; endosseous implantation; peri-implantitis; periodontitis; tooth mobility.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Alveolar Bone Loss* / diagnostic imaging
Dental Implants* / adverse effects
Humans
Peri-Implantitis* / diagnostic imaging
Retrospective Studies
Suppuration
Tooth*

Substances

Dental Implants