Long-Term Biological Complications of Dental Implants Placed Either in Pristine or in Augmented Sites

Consensus Statement 1: Patients receiving implants in augmented sites display comparable prevalence of peri-implant mucositis compared with patients receiving implants in pristine sites

There is evidence that patients receiving implants in augmented sites may display a comparable prevalence of peri-implant mucositis compared with patients receiving implants in pristine sites. Patients with implants placed in pristine sites have a prevalence of peri-implant mucositis of 22.4% (95% CI: 6%–38%) compared with a prevalence of 19.6% (95% CI: 0%–40%) for patients with implants in augmented sites. This statement is based on 1 RCT, 1 case–control study, and 4 case series studies.

Consensus Statement 2: Prevalence of peri-implantitis in patients with implants in augmented sites is more variable and less predictable than patients with implants in pristine sites

There is evidence that the long-term prevalence of peri-implantitis in patients with implants in pristine sites and augmented sites is low. The prevalence of peri-implantitis in patients with implants in augmented sites is more variable and less predictable compared with the prevalence in patients with implants in pristine sites. The weighted mean prevalence of peri-implantitis in patients with implants in augmented sites was 17.8% (95% CI: 0%–37%) compared with that of 10.3% (95% CI: 4%–17%) in patients with implants in pristine sites. This statement is based on 1 RCT, 1 case–control study, and 4 case series studies.

Consensus Statement 3: Long-term prevalence of implant failure (loss) in patients with implants in pristine sites and augmented sites is low

There is some evidence that the long-term prevalence of implant failure (loss) in patients with implants in pristine sites and augmented sites is low. The weighted mean prevalence of implant failure (loss) in patients with implants in augmented sites was 3.6% (95% CI: 0%–8%) compared with that of 2.5% (95% CI: 1%–4%) in patients with implants in pristine sites. This statement is based on 1 RCT, 1 case–control study, and 4 case series studies.

Consensus Statement 4: In patients with a history of treated periodontitis receiving implants in pristine sites, compliance with regular supportive care yields lower long-term implant failure (loss) compared with patients not complying with regular supportive care

In patients with a history of treated periodontitis (moderate and severe) receiving implant therapy in pristine sites, compliance with regular supportive care yields lower long-term implant failure (loss) compared with patients not complying with regular supportive care. This statement is based on 1 study.

Consensus Statement 5: There is limited evidence concerning the effect of regular supportive care in patients with a history of treated periodontitis receiving implants in augmented sites

There is limited evidence concerning the effect of regular supportive care in patients with a history of treated periodontitis receiving implants in augmented sites. This statement is based on 1 study.

For the long-term monitoring of biological complications, at what time points should implants placed in augmented sites be assessed?

The time of completion of the implant-supported prosthesis should be used as a baseline for assessment. Similar to implants placed in pristine sites, implants placed in augmented sites should have time-points for subsequent assessments determined by the individual risk profile of the patient.

Do patients with implants in augmented sites require specific supportive care?

Patients with implants in augmented and pristine sites should both be enrolled in regular supportive care. Special consideration should be given to periodontally susceptible patients with implants placed in augmented sites.