Suppuration as diagnostic criterium of peri‐implantitis

Abstract

Background

Suppuration (SUP) as a diagnostic parameter for monitoring dental implants is not yet well understood. The retrospective clinical and radiographic study was therefore carried out to investigate the patient, implant and site characteristics among individuals exhibiting SUP.

Material and methods

Demographic characteristics and clinical parameters were recorded. Radiographic features were analyzed using cone‐beam computed tomography (CBCT). Peri‐implantitis was defined based on the consensus report of Workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions: probing pocket depth (PPD) ≥ 6 mm, presence of bleeding on probing (BOP) and/or SUP on gentle probing, and radiographic bone loss (MBL) ≥3mm. SUP was graded according to profuseness (dot vs. line/drop) and time after probing (≥15 seconds vs. <15 seconds after probing vs. spontaneous). Simple binary logistic regression models were estimated using generalized estimation equations (GEE) in order to explain the probability of SUP based on demographic, clinical and radiographic variables.

Results

A total of 111 eligible patients (n_implants = 501) were assessed. Of them, 57 (n_implants = 334) were diagnosed with peri‐implantitis according to the established case definition, and of these individuals, 31 (n_implants = 96) presented SUP. Therefore, the prevalence of SUP was 27.92% in the total sample size and 54.38% in peri‐implantitis patients. Overall, 28.74% implants displayed SUP within peri‐implantitis patients. SUP was more frequently found at buccal sites (51%) and proved less prevalent at mesio‐lingual sites (16.7%). Defect morphology (OR = 6.59; p = 0.004), PPD (OR = 1.63; p = 0.024) and MBL (OR = 1.35; p = 0.010) were significantly associated with the presence of SUP. Likewise, defect morphology (p = 0.02), PPD (p = 0.003) and MBL (p = 0.01) were significantly correlated with the grade of SUP.

Conclusion

The presence and grade of suppuration are associated with peri‐implant bone loss, probing pocket depth and defect morphology in peri‐implantitis patients.

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https://aap.onlinelibrary.wiley.com/doi/abs/10.1002/JPER.20-0159?af=R