J Clin Periodontol 2009;36:357-63Extent of peri-implantitis-associated bone lossFransson C et alGöteborg, Sweden

Material: 1070 implants from 182 subjects examined from 1 – 23 years follow-up

Definition: Peri-implantitis = bleeding on probing, pus & probing pocket depth ≥ 6mm

Results: About 40 % of implants in each subject were affected by peri- implantitis-associated bone loss

22

Long-term (> 5 years) appearance ofsingle- tooth implant crowns • gingival blue-coloring • progressive infraocclusion • ”root” exposure

World J Orthod nr. 3, 2006

44

Godtfredsen 2008

Long-term follow-up (5 yrs) of implants

Score 1: No blue-coloring ........ 43%Scores 2-4: Blue-coloring or visible margin ........ 57 %

of treated cases at follow-up after 5 years

55

Why labial bone loss & discoloration of gingiva in front of implants

•Alveolar bone in front is built from endosteally formed bone (except from narrow strip at crest where periosteal bone is formed due to the continuous tooth eruption)

•Endosteal bone is more porous than periosteal bone (= more sensitive to resorption)

•The labial bone in front of implants does not hold (disturbed vascularization, changes of mechanical stimuli, etc.)

Rotational Palatal Pedicle GraftRotational Palatal Pedicle Graft

Stig K. Osterberg DDS MSD

Port Townsend WA

Stig K. Osterberg DDS MSD

Port Townsend WA

Eur J Orthod 2001;237:15-31Orthodontic aspects of the use of oral implants in adolescents: a 10-year follow-up studyThilander B, Ödman J, Lekholm UGöteborg, Sweden

J Clin Periodontol 2004;31:1024-8

Long-term vertical changes of the anterior maxillary teeth adjacent to single implants in young and mature adultsA retrospective studyBernard JP, Schatz JP, Christou P, Belser U, Kiliaridis SGeneva, Switzerland

C Infra-occlusion

99

Clin Impl Dent & Related Research 2005;7:200-208