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 Graft

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;31:1024-8Long-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