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• W3089774014 abstract "Dental implants are expected to improve the quality of life of a patient by providing a fixed, long-term replacement for missing teeth. Development of peri-implantitis, however, is a major hindrance for a patient, as it requires additional treatment to rectify bone loss and replace teeth. Patient screening prior to implant placement is becoming paramount as life expectancy increases and comorbid conditions continue to rise. Risk factors, such as smoking, diabetes, anti-resorptive agents, and other individual patient factors, should be considered while evaluating a patient for treatment.1 Contraindications for treatment, such as a recent myocardial infarction or in-progress chemotherapy, should also be considered.2 We sought to investigate whether a multidisciplinary team discussion for implant treatment planning would reduce poor dental implant outcomes. In order to assess whether a patient was a good candidate for implant treatment, an implant committee was created in 2012 at the Philadelphia VA Medical Center to discuss prospective implant cases. This team consisted of restorative dentists, prosthodontists, periodontists, and oral and maxillofacial surgeons. The committee took a wholistic approach to patient care by focusing on certain risk factors it believed could decrease implant success. Risk factors assessed included medical history, smoking status, medications, and certain laboratory tests, such as hemoglobin A1c (HbA1c) levels. After thorough review, the committee decided whether an implant would be appropriate at that time or whether specific factors needed to be improved before treatment. A retrospective cohort study was performed to evaluate implants placed between 2006 and 2013. Medical and dental encounter notes were used to determine whether a case was approved by an implant approval committee, among other factors such as medications and HbA1c levels. Peri-implantitis was defined as radiographic evidence of bone loss of osseointegrated implants in conjunction with inflammatory signs, such as bleeding on probing, peri-implant probing depth of 5 or more millimeters, with or without suppuration. A minimum follow-up period of 5 years after placement was necessary to be included in the analysis. Of the 1362 implants in 398 unique patients, 889 implants in 285 patients met the inclusion criteria. Descriptive statistics were computed using the SAS system (SAS Institute Version 9.4, 2002-2012, Cary, NC). The predictive variable was implant committee approval. The primary outcome variable was peri-implantitis, with P < .05 used to define statistical significance. Of the 889 implants that met the inclusion criteria, 220 (24.7%) were approved prior to placement by the implant committee established in 2012. For the 669 implants that were not reviewed and approved by the implant committee, 166 (24.8%) developed peri-implantitis. Patients who had implant committee approval had a 34.7% decreased risk of peri-implantitis (OR 0.653; 95% CL 0.443, 0.963) compared to patients who did not receive approval by the committee of experts (P = .0313). The results from this retrospective cohort study reveal that a group of experts analyzing patient health status before placing implants is a protective factor against peri-implantitis. This finding is clinically significant because it decreases the chance of implant complications, presumptively improving patient quality of life and satisfaction. Ideally, similar implant approval committees could be implemented in other hospitals. Further studies should be conducted to confirm this association as well as develop more criteria for implant committees to analyze before treatment." @default.
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• W3089774014 date "2020-10-01" @default.
• W3089774014 modified "2023-09-27" @default.
• W3089774014 title "Implant Committee Approval as a Protective Factor Against Peri-implantitis" @default.
• W3089774014 doi "https://doi.org/10.1016/j.joms.2020.07.128" @default.
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