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Two cavities triple the risk of having peri-implantitis

 Untreated interproximal caries significantly increases the risk of peri-implantitis.

Two cavities triple the risk of having peri-implantitis

Caries is not only an infectious oral disease that has a certain causal relationship with periodontal diseases but its presence can also be related to peri-implantitis, present in approximately 1 in 4 people with dental implants. Now a study reveals a significant link between dental caries and certain nutritional habits with the development of this infection that affects dental implants and, in many cases, causes them to fail.

The study has explored the possible relationship between caries and peri-implantitis in partially dentate patients (> 20 teeth in the mouth), as well as analyzing the influence of a series of factors related to the patient's lifestyle, such as nutrition, socioeconomic status, or dry mouth (xerostomia) to implement effective prevention measures in patients with dental implants.
To this end, 169 patients and a total of 311 implants were evaluated. Up to 92% of the patients had at least one caries and 25% of the participants were diagnosed with peri-implantitis. The study showed that those patients with more than two caries had three times the risk of developing peri-implantitis. An interesting finding was that untreated interproximal filling or caries adjacent to dental implants significantly increase the risk of peri-implantitis, especially when located in the mesial region.

On the other hand, the research reveals that certain lifestyle habits are related to an increased risk of developing peri-implantitis. Patients who were habitual consumers of an exaggerated intake of sugar and who did not adhere to the Mediterranean diet kept their implants in a worse state of health, and it was also observed that patients with dry mouth showed a certain tendency to a higher risk of developing peri-implantitis.

Important clinical implications

These findings, in the opinion of the UIC researchers, raise several clinical implications. First, the presence of caries in partially dentate patients with implants could be considered as a possible influencing factor in the occurrence and severity of peri-implant disease; therefore, the patient's caries risk, as well as oral hygiene and lifestyle, should be assessed and monitored throughout implant therapy.
The study also shows how certain lifestyle habits are associated with an increased risk of developing peri-implantitis.

In addition, the authors of the study point out the need to pay special attention to untreated interproximal fillings or caries adjacent to dental implants, since their presence could denote poor interproximal oral hygiene, which could locally predispose to peri-implant inflammation.

In addition, this work places the role of the periodontist and hygienist as fundamental when recommending to the patient, from the dental chair itself, healthy eating habits and lifestyles that allow altering the bacterial metabolism and reducing the inflammatory load, thus helping to prevent caries and periodontal and peri-implant diseases.

Caries and periodontal/peri-implant diseases

Caries and periodontitis are remarkably prevalent infectious diseases occurring in approximately 30% and 40% of the population, respectively. It is currently assumed that both caries and periodontitis often co-occur, with a higher proportion of caries being observed in patients with periodontitis and vice versa.  In addition, both pathologies are considered chronic and complex disorders that share certain etiological factors, such as bacterial biofilm, genetics, nutrition, tobacco, diabetes, hyposalivation, among others (although with somewhat different physiological processes).

Based on this reality, and given that peri-implantitis is a 'mirror' pathology of periodontitis (but in dental implants), the existence of a close association with caries is considered. It is estimated that approximately 24% of patients with dental implants develop peri-implantitis; its cause lies mainly in the accumulation of bacterial biofilm, although a series of local, environmental, and/or genetic factors may also play a role.

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