Over the last decades, dental implants have become a commonly used treatment alternative to removable dentures. In Sweden alone around 100000 dental implants are placed each year. Around 40,000 individuals are treated with dental implants as a substitute for teeth that have been lost. The situation is similar in Europe and for example in Germany and Italy the numbers approach one million implants placed each year. Many of these implants are replacing teeth that have been lost due to periodontal disease.
Several longitudinal studies have reported so-called “survival rates” (meaning that the implant is still present in the oral cavity) of around 90-95 % over periods of 5-10 years. Most of the implant losses occurred during the healing phase and the first year after placement. For many years, implants were considered to be “teeth for life” if the implant was successfully osseointegrated, and when reports on infections around implants were published in the scientific literature this was considered to be a rare phenomenon. During the last years it has however been obvious that biological complications do occur around implants and that this may be a frequent problem for patients that have had their implants for many years. Recent published data indicate that as many as 28-56 % of the patients with implants show peri-implantitis on one or more implants after 5-10 years. If a patient develops peri-implantitis, often several implants are affected. Smoking and bad oral hygiene have been associated with presence of peri-implant disease. Patients with a history of periodontal disease may be genetically predisposed to develop a more pronounced inflammatory reaction resulting in tissue destruction around their teeth, leading to tooth loss. There is no reason to believe that such an inflammatory reaction should be different at implant sites in these individuals. Accordingly periodontitis patients have been reported to be at higher risk for developing peri-implantitis. If a large number of implants are placed in such high-risk individuals we may be facing high percentages of individuals with problems related to their implant therapy in the future. Infections around implants are difficult to treat and such infections will ultimately result in implant loss. |
