CLINICAL CHARACTERISTICS OF DYSTROPHIC-INFLAMMATORY PERIODONTAL DISEASES IN PATIENTS WITH SECONDARY EDENTULISM AT THE DENTAL IMPLANT PLANNING STAGE
DOI:
https://doi.org/10.35220/2523-420X/2026.2.11Keywords:
dental implantation, secondary edentulism, generalized periodontitis, alveolar bone resorption, pre-implant preparation, AAP/EFP classification, osseointegration.Abstract
The success of dental implantation directly depends on the baseline condition of the prosthetic bed tissues. A history of dystrophic-inflammatory periodontal diseases significantly worsens the treatment prognosis due to bone tissue deficiency and aggressive microbial load. The aim of the study was to conduct a comprehensive clinical analysis and determine the course characteristics of dystrophic-inflammatory periodontal diseases in patients with secondary edentulism at the stage of planning dental implantation. Materials and methods. A cross-sectional clinical and radiographic examination of 176 patients with secondary edentulism was conducted. A targeted cohort (n=119) of individuals aged 18 to 60 with concomitant periodontal pathology was formed. Dental status assessment was performed using a standardized UNC-15 probe, digital orthopantomography, and cone- beam computed tomography. The diagnosis was verified according to the AAP/EFP (2017) criteria. Statistical data processing was performed using SPSS v.26.0 software. Results. A high prevalence of periodontal diseases among the examined patients was established (81.82%). Generalized periodontitis dominated in the structure of lesions (82.64%), and its frequency significantly increased in parallel with the age of the patients, p<0.01. The most common clinical scenario was Stage II, Grade B periodontitis, diagnosed in 49.58% of individuals. At the same time, over 42% of patients had severe forms of pathology (Stages III and IV) with clinical attachment loss ≥5 mm, the presence of deep periodontal pockets, furcation involvement, and complex intraosseous defects. Conclusions. It is proven that the absolute majority of patients with secondary edentulism have pronounced dystrophic-inflammatory periodontal changes accompanied by a critical deficit of alveolar bone. This objectively classifies them as a high-risk group and justifies the need for thorough preoperative periodontal sanitation and the application of guided bone regeneration techniques prior to implant placement.
References
Buser, D., Sennerby, L., & De Bruyn, H. (2017). Modern implant dentistry based on osseointegration: 50 years of progress, current trends and open questions. Periodontology 2000, 73(1), 7-21. https://doi.org/10.1111/prd.12185
Derks, J., & Tomasi, C. (2015). Peri-implant health and disease. A systematic review of current epidemiology. Journal of Clinical Periodontology, 42(S16), S158-S171. https://doi.org/10.1111/jcpe.12334
Chappuis, V., Araújo, M. G., & Buser, D. (2017). Clinical relevance of dimensional bone and soft tissue alterations post-extraction in esthetic sites. Periodontology 2000, 73(1), 73-83. https://doi.org/10.1111/prd.12167
Kassebaum, N. J., Bernabé, E., Dahiya, M., Bhandari, B., Murray, C. J., & Marcenes, W. (2014). Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. Journal of Dental Research, 93(11), 1045-1053. https://doi.org/ 10.1177/0022034514552491
Frencken, J. E., Sharma, P., Stenhouse, L., Green, D., Laverty, D., & Dietrich, T. (2017). Global epidemiology of dental caries and severe periodontitis – a comprehensive review. Journal of Clinical Periodontology, 44(S18), S94- S105. https://doi.org/10.1111/jcpe.12677
Hajishengallis, G. (2015). Periodontitis: from microbial immune subversion to systemic inflammation. Nature Reviews Immunology, 15(1), 30-44. https://doi.org/ 10.1038/nri3785
Roccuzzo, M., Layton, D. M., Roccuzzo, A., & Heitz-Mayfield, L. J. (2018). Clinical outcomes of peri- implantitis treatment and supportive care: A systematic review. Clinical Oral Implants Research, 29(S16), 331-350. https://doi.org/10.1111/clr.13287
Quirynen, M., De Soete, M., & van Steenberghe, D. (2002). Infectious risks for oral implants: a review of the literature. Clinical Oral Implants Research, 13(1), 1-19. https://doi.org/10.1034/j.1600-0501.2002.130101.x
Elgali, I., Omar, O., Dahlin, C., & Thomsen, P. (2017). Guided bone regeneration: materials and biological mechanisms revisited. European Journal of Oral Sciences, 125(5), 315-337. https://doi.org/10.1111/eos.12364
Caton, J. G., Armitage, G., Berglundh, T., Chapple, I. L. C., Jepsen, S., Kornman, K. S., & Tonetti, M. S. (2018). A new classification scheme for periodontal and peri-implant diseases and conditions – Introduction and key changes from the 1999 classification. Journal of Clinical Periodontology, 45(S20), S1-S8. https://doi.org/10.1111/ jcpe.12935
Tonetti, M. S., Greenwell, H., & Kornman, K. S. (2018). Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. Journal of Clinical Periodontology, 45(S20), S149-S161. https://doi.org/10.1111/jcpe.12945
World Medical Association. (2013). World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA, 310(20), 2191-2194. https://doi.org/10.1001/jama.2013.281053
World Health Organization. (2013). Oral health surveys: basic methods – 5th ed. World Health Organization. https://iris.who.int/handle/10665/97035 14. Ranganathan, P., Pramesh, C. S., & Buyse, M. (2015). Common pitfalls in statistical analysis: Clinical versus statistical significance. Perspectives in Clinical Research, 6(3), 169-170. https://doi.org/10.4103/2229-3485.159943
