Clinical Update

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Each month, the clinical update is published online and in the Victorian Dentist. There are 11 clinical updates per year, corresponding with the distribution of the Victorian Dentist from February to December. This service is available to ADAVB and ADATas members only. Members can log in to view and answer the clinical update questions. If you answer at least eight out of 10 questions correctly, you will receive one hour of scientific CPD.

Please note: Each new clinical update will be available from the first business day of each month.

Diagnosis of peri-implantitis in the absence of baseline data: A diagnostic accuracy study

Romandini M, Berglundh J, Derks J, Sanz M, Berglundh T. Clin Oral Impl Res 2021 32:297-313 doi: 10.111/clr.13700

Compiled by Dr Sarah Chin

Introduction

Peri-implantitis is a pathological condition occurring around dental implants resulting from mucosal inflammation and loss of supporting bone due to plaque accumulation. The prevalence of peri-implantitis depends on the case definition and varies from 10–40 per cent. Progression of peri-implantitis follows a non-linear pattern and may result in implant loss.

The 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions (2017 WWP) presented a case definition referring to baseline Probing Pocket Depth (PPD) and marginal bone levels to diagnose peri-implantitis with an increase in PPD, bleeding on probing (BoP) and/or suppuration on probing (SoP) with radiographic evidence of bone loss.

Baseline clinical information is often not available. Secondary case definitions have been suggested. At the 2017 WWP, a suggested secondary case definition in addition to BoP/ SoP, included the findings of a PPD ≥6mm together with a bone level of ≥3mm apical to the most coronal portion of the intra-osseous part of the implant. The VIII European Workshop on Periodontology (VIII EWP) suggested a vertical distance ≥2mm from the expected marginal bone level in radiographs together with BoP/SoP.

No studies have validated the proposed secondary case definitions. The aim of the present study was to evaluate the diagnostic accuracy of clinical and radiographic evaluations made at a single time point during follow-up in identifying (i) a history of bone loss and (ii) the presence of peri-implantitis, as assessed by direct evidence.

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