Site Related Risk Factors

Local predisposing factors such as soft tissue characteristics, implant position and prosthetic design were found to be associated with the occurrence of peri-implant diseases. Bone quality, the nature of the bone (native vs. grafted) and other hard tissue characteristics might also be influential when the implant will be exposed to peri-implant inflammation and infection. Robust data points toward the strong link between residual sub-mucosal cement or other plaque retentive factors and peri-implant diseases.

Emerging data are confirming the influence of certain local factors might have upon the onset and development of disease, as they induce plaque accumulation. Conceptually, predisposing factors refer to conditions that places the given element (dental implant)/individual (patient) at risk of developing a problem (peri-implantitis). If this factor is not controlled after diagnosing and arresting (or not) the problem (peri-implantitis), represents a perpetuating factor that maintains the problem.^8-10 Other site-specific factors such as previous implant failure, previous chronic periapical infections etc., should also be considered.

Based on the existing literature in the field of periodontology, peri-implant attached keratinized gingiva is beneficial in patients with neglected oral hygiene; whereas patients with adequate oral hygiene measures may not benefit from peri-implant attached keratinized gingiva.^8,9

Figure 5: Peri-implant keratinized gingiva deficiency.

Figure 5: Peri-implant keratinized gingiva deficiency.