Peri-implant tissue health in reconstructed atrophic maxillae - report of 88 patients and 470 implants

The aim of this study was to evaluate the soft-tissue health around 470 imp lants placed in the upper jaw of 88 patients with severe maxillary atrophy. All patients underwent a reconstruction procedure which included a composi te bone grafting from the iliac crest to the maxillary sinus. Evaluation wa s performed at a mean implant Lifetime of 21.6 +/- 10.9 months. The followi ng parameters were used: probing depth, plaque-, gingival-, bleeding index and width of the buccal keratinized mucosa. They were calculated as means f or each implant and related to the type of superstructure and the thickness of the original sinus floor. (higher or lower than 5 mm). A high percentag e of bleeding on probing was observed in obviously clinically healthy peri- implant pockets. Bleeding on probing and deeper probing depth were especial ly observed in the group with severe maxillary atrophy (less than 5 mm init ial height of the sinus floor.) There was a significant increase in mean pe ri-implant probing depth and gingiva index in overdentures versus fixed bri dges. No differences were observed with respect to the width of the keratin ized buccal mucosa. lt was concluded that implants in the reconstructed max illa and supporting overdentures had a higher risk for bone loss, based on the worse peri-implant tissue health observed.