Risk Factors For Peri-implantitis

Objectives With the increasing popularity of the clinical application of implants,dentists must face the problem of maintaining the long-term stability of implants in the oral cavity,which is closely related to the hard and soft tissues around the implants.The purpose of this study was to conduct meta analysis on some potential risk factors of peri-implantitis that had not yet been determined by consulting relevant studies and systematic reviews of risk factors for peri-implantitis,so as to provide a valuable data for clinical prevention of peri-implantitis.Methods The Cochrane Library,PubMed,Embase,CNKI and other Chinese and English databases were searched to find all related literature on the relationship between peri-implantitis and keratinized gingival width,regular maintenance,emergence angle of the prosthesis and the mode of restoration from time databases established to March 1,2021.Then two investigators screened the literatures,extracted relevant data,and evaluated the quality independently.STATA15.0 software were used for meta analysis,either fixed effect model or random effect model was used according to the magnitude of heterogeneity.Results A total of 11 articles were included in this study,including 3677 implants,including:1)Crown retention mode group included four study with 1916 implants.The heterogeneity test results showed that I~2=90.7%>50%,P<0.001,indicating a heterogeneity,combined with random effects model,and combined effect of OR 5.73,95%CI 1.21～27.20,which showed a statistically significant difference,suggested that the prosthesis with adhesive fixation had a significantly higher incidence of peri-implantitis than the prosthesis with screw fixation.2)Prosthesis emergence angle group included two study with 799implants.The heterogeneity test results showed that I~2=82.9%>50%,P=0.015,indicating a heterogeneity,combined with random effects model,and combined effect of OR 5.29,95%CI 1.49～18.82,which showed a statistically significant difference,indicated that the incidence of peri-implantitis was higher when the Prosthesis emergence Angle≥30°.3)The keratinized mucosa width group included three studies with 1394 implants.The heterogeneity test results showed that I~2=70.4%>50%,P=0.034,indicating a heterogeneity,combined with random effects model,and combined effect of OR 3.95,95%CI 1.35～11.56.The results were statistically different,indicated that peri-implantitis was more likely to occur when the width of peri-implant keratinized mucosa<2mm.4)Regular maintenance group included four study,a total of 484 implants,heterogeneity test results showed that I~2=11.0%<50%,P=0.338,which showed no obvious heterogeneity,fixed effects model was used,and the effect of OR 3.22,95%CI 2.02～5.14,the results was statistically difference,indicated that patients treated for maintenance regularly could reduce the risk of peri-implantitis.Conclusions Under the limitations of this system review and meta-analysis,the following conclusions could be drawn:1)Patients with regular maintenance after implantation treatment could effectively reduce the incidence of peri-implantitis;2)When the keratinized mucosa width around the implant>2mm,patients had a lower risk of peri-implantitis;3)The emergence angle of the prosthesis had a significant influence on the occurrence of peri-implantitis,it was generally believed that the incidence of peri-implantitis is lower when emergence angle<30°;4)the prosthesis with adhesive fixation had a significantly higher incidence of peri-implantitis than the prosthesis with screw fixation.At the same time,future research is highly encouraged to reassess the impact of the new data.Figure 11;Table 3;Reference 133...