S. HECKMANN *1, CH. BRANDTNER 2, N. MÜLLER 1, H. HUNOLD 1, TH. DIEPGEN 3 (1 Policlinic of Prosthodontics at Erlangen University, Germany, 2 Clinic of Oro-Maxillofacial Surgery at Salzburg University, Austria, 3 Dermatological Clinic and Policlinic at Erlangen University, Germany)
In 57 patients, the tissue surrounding implant supported crowns (n=57, ITI-Bonefit implants, average usage > 4 years) and the gingival tissue of opposite crowned teeth (n=38, average usage > 4 years) or natural teeth (n=19) were investigated. The influence of general factors such as age, gender, location, saliva consistency and occlusion were considered. Furthermore Plaque Index (PI), Gingival Index (GI), Sulcus Fluid Flow Rate (SFFR) and Periotest values (PTV) were recorded. X-rays of the implants, crowned and natural teeth were taken.
The morphological and morphometrical values of the gingival tissue and peri-implant tissue were compared. The statistical evaluation was carried out using the Chi-squared and Mann-Whitney tests and variance analysis.
The results showed that healthy gingival and peri-implant tissues were significantly (p<0.001) correlated with good oral hygiene. Less plaque was observed on teeth without restoration and on implant supported crowns. Restored teeth showed more frequent (p<0.001) inflammation of the gingival margin which correlated with an increased SFFR. The GI however. did not show a significant difference. The PTV of the teeth showed a mean value of 2.93. The implants´ PTV of -2.28 was well within the range of osseointegration. Implant pocket depths were on average 1 mm deeper than those of the crowned teeth. The x-ray, evaluation showed an additional vertical bone loss of about 1.5 mm in the crowned teeth compared to the bone loss around the implants. Circular angular-type bone loss was found three time more frequently in the implants group. With increased usage period. the results for crowned teeth gingival tissue and peri-implant tissue showed only, slight differences. Other factors were less relevant to the clinical appearance.
The results are related to those of other authors and the decisive impact of the restoration on the gingival margin tissue and the peri-implant tissue is discussed.