| dc.description.abstract | Background: Peri-implant disease has the potential to cause loss of implant stability and
subsequent implant failure. Non-invasive, quantitative measures of implant stability offered
by Osstell® and Periotest® devices may have the potential to aid in peri-implant disease
diagnosis and monitoring post-operative healing and implant stability.
Aims: To assess the impact of peri-implantitis therapy on peri-implant parameters and implant stability using both devices. To determine the degree of correlation between devices and if one correlates more superiorly than the other with clinical and radiographic changes post-operatively. To ascertain the most appropriate time to re-evaluate implants following peri-implantitis treatment.
Materials & Methods: A prospective clinical study on a cohort of Dublin Dental
University Hospital subjects who had been diagnosed with peri-implantitis was completed.
Baseline data collection included several clinical and radiographic peri-implant parameters,
as well as ISQ and PTV levels using the Osstell IDX® and Periotest Classic® devices,
respectively. Patients were assigned to receive either non-surgical therapy, resective surgery or regenerative surgery encompassing barrier membranes, Leucocyte-platelet rich fibrin and hard tissue grafting. Follow-up measurements were repeated at 3, 6 and 12-months. SPSS® software was used for statistical analysis. The statistical significance of changes in peri-implant parameters and implant stability over 12-months, as well as treatment subgroup
analysis, was determined using One-Way ANOVA or Kruskal-Wallis H tests. Pearson and
Spearman correlation coefficients were used to test correlation between changes in peri-implant parameters and implant stability and between Osstell® and Periotest® devices.
Results: 26 subjects were included with a total of 85 implants receiving treatment.
Statistically significant improvements in all peri-implant and radiographic parameters over
the 12-months were found, with the exception of keratinized tissue levels. Improved implant
stability as indicated by increased ISQ and decreased PTV levels, was observed but changes
were not significant. The greatest clinical improvements were seen for implants which
received hard tissue grafting, with a mean bone gain of 1.13mm (SD 1.58), mean probing
depth reduction of 3.00mm (SD 3.54) and mean attachment level gain of 2.75mm (SD 1.99)
at 12-months. Strong correlations were found in the hard tissue grafting subgroup between
changes in mean ISQ levels and deepest probing depths (r=-.743, p=.000), average probing
depths (r=-.697, p=.000) and clinical attachment levels (r=-.717, p=.000) at 12-months.
Moderate correlations were found in the hard tissue grafting subgroup between changes in
mean PTV levels and average probing depths (r=.585, p=.028) and clinical attachment levels
(r=.582, p=.022) at 12-months. Strong correlations were found between Osstell® and
Periotest® devices at each study timepoint, with the strongest correlation found at 12-months(r=-.808, p=.000; mean ISQ 66.67 Vs mean PTV -2.47). Regenerative subgroups which
received a barrier membrane (r=-.801, p=.005) and hard tissue graft (r=-.951, p=.000) yielded strong negative correlations between devices at 12-months.
Conclusions: All treatment modalities resulted in improved clinical and radiographic periimplant parameters over 12-months. Implant stability improved post-treatment, as indicated by increased ISQ and decreased PTV levels, however, such changes were not statistically significant. A high degree of correlation was found between devices when used to monitor changes in implant stability, particularly following regenerative interventions. While both devices may be used as complimentary diagnostic tools in quantifying post-operative changes following peri-implantitis treatment, Osstelltm correlated more accurately with changes in clinical and radiographic parameters than Periotesttm. Within the limitations of this study, 12-months appears to be the most appropriate time to re-evaluate the stability of implants treated for peri-implant disease. | en |
