The influence of prosthetic design factors on the development of peri-implantitis: literature review

Abstract

Introduction: Oral rehabilitation of edentulous patients using dental implants has become widely adopted in dentistry since last decades. Dental implant provides retention and support for a fixed or removable dental prosthesis. Several factors affects the success of dental implants including prosthetic design factors. Our aim is to review the literature shed the light on the dental implant’s prosthetic related risk factors in literature and their influence on the development of peri-implant disease. Methods: A research in PubMed was conducted to identify studies using the following key words: (Peri-implantitis OR Peri-implant disease) AND (Prosthetic). The inclusion criteria were identified as studies published in English; studies describe prosthetic design effect on peri-implant tissue, original studies. The exclusion criteria defined as studies published in other language, case reports, and experimental studies. Results: Our search identified about 448 publications, from which 31 met the inclusion criteria. There are four prosthetic design factors contribute to the peri-implant disease. Bacterial colonization can come from the screw loosening in screw retained implant, although it’s superior in cement-retained due to the the excess cement remnants in the sulcus. Occlusal overload can lead to marginal bone loss (MBL) if it exceeds a particular limit. In addition, emergence angle (EA) > 30 evidentially leads to more marginal bone loss compared to the emergence angle (EA) < 30. The convex profile found to be more associated with development of peri-implantitis. Marginal bone loss occurs more with abutment height less than 2 mm. Conclusion: Prosthetic design factors are potential causes for peri-implant disease. In cement-retained dental implant, cement remnants is a causative factor. A controlled occlusion; emergence angle (EA) < 30 degrees and correct abutment selection are essential to avoid marginal bone loss. Key words: Peri-implantitis, Peri-implant disease, Prosthetic.