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Effects of Periodontitis and Jaw Morphology on Radiographic Dimensional Reduction of Anterior Mandibular Implants: A
Xiaofan Chen1, Yifan Xu1, Weijie Zhang1
1Shanghai Engineering Research Center of Tooth Restoration and Regeneration & Tongji Research Institute of Stomatology, Shanghai, China; Department of Oral Implantology, Shanghai Tongji Stomatological Hospital and Dental School, Tongji University, Shanghai, China.
Introduction And Aims:
To evaluate the effects of periodontitis severity and residual alveolar morphology on labial radiographic dimensional reduction during the first 6 months after anterior mandibular implant placement with simultaneous guided bone regeneration (GBR).
Methods:
Fifty-nine patients with 87 implants were enrolled. Periodontitis was classified as No/Mild or Moderate/Severe. Residual ridge morphology was categorized into 4 types using the Al-Faraje system. Dimensional changes were quantified by measurements based on cone-beam computed tomography (CBCT) scans. We evaluated variables such as periodontitis severity, jawbone classification, implant timing, position, gender, age, the number of implant site, and implant surface. A linear mixed-effects model (LMM) analysis was performed to identify associations between risk factors and labial grafted bone dimensional reduction.
Results:
Significant labial radiographic dimensional reduction occurred within 6 months postsurgery. LMM revealed that Moderate/Severe periodontitis was independently associated with increased vertical (ΔBH) and horizontal (ΔBW0, ΔBW1, ΔBW3) dimensional reduction (adjusted p < .05). Al-Faraje Class II/III ridges were independently associated with greater horizontal radiographic dimensional reduction at the crestal level (ΔBW0, adjusted p < .05). Implant timing, gender, the number of implant site, and implant surface showed no significant effects.
Conclusions:
Moderate/severe periodontitis was independently associated with greater early vertical and horizontal labial radiographic dimensional reduction. Al-Faraje Class II/III jaw morphology was primarily associated with increased dimensional reduction at the crestal bone level. Preoperative assessment of periodontal status and alveolar ridge morphology is essential for risk stratification and personalized treatment planning to improve bone stability and clinical outcomes.
Clinical Relevance:
Identifying key factors helps to prevent labial radiographic dimensional reduction around anterior mandibular implants with GBR and supports personalized clinical decision-making.