Peri-implant mucosal aspects of ITI implants supporting overdentures. A five-year longitudinal study

Sixty-six ITI implants placed in the mandible of 33 edentulous elderly patients (mean age: 69 years) were observed longitudinally for 5 years. The implants served as overdenture anchorage either by means of a connecting bar or single spherical attachments. During the study period, 2 implants failed (one because of a peri-implant lesion and one because of a fracture) and had to be removed. At the beginning of the study, all implants were osseointegrated and had successfully been in function for 3-5 months. Oral hygiene practices and the peri-implant mucosal status were assessed according to the criteria of conventional periodontal parameters. Approximately 50% of the implants had been installed into lining mucosa and hence were to surrounded by keratinized mucosa. The peri-implant mucosal tissue was maintained healthy during the whole observation period, and no or only minimal loss of attachment was observed. The probing depths averaged approximately 3 mm. At the end of the study, orthopantomographic radiographs were obtained from all patients to assess the peri-implant bony structures. Small local angular bony defects were detected on 16 implants (22%) in 12 patients. Slightly increased probing depths were observed when angular bony defects were present. Loss of attachment was significantly less frequent when the implants had been placed following a prolonged period of edentulousness (> 5 years). This study demonstrated that advanced age, reduced dexterity of elderly patients and environmental conditions of overdentures do not represent a higher risk for the development of peri-implant lesions.