Post-insertion peri-implant tissue assessment: a longitudinal study.
The peri-implant gingivae act as a biological barrier that prevents the ingress of plaque bacteria, oral debris, and saliva components into the internal environment of the jaw. The integrity of this barrier around a total of 163 Steri-Oss HA-coated threaded root-form implants placed in 48 patients was examined at six-month intervals over a 42-month time period, beginning at the time of final prosthetic placement. Five clinical parameters for tissue assessment were used: Mean Implant Sulcus Readings (MISR), Mühlemann Sulcus Bleeding Index (SBI), Miller's Mobility Index (MI), bone loss readings (BL), and gingival condition (GI). Bone loss and mobility were negligible throughout the 42-month study period. At six months post-insertion, 58.6% of the Mean Implant Sulcus Readings exceeded 4 mm. Gingival conditions and bleeding response also were non-ideal in a significant number of cases (52.9 and 62.1%, respectively). However, all three of these assessments later showed dramatic improvement. Patients' inability to "deplaque" their newly acquired implant prostheses effectively may be a factor contributing to the high incidence of undesirable pocket depths and non-optimal gingival appearance at the first six-month assessment point. Attainment of the necessary skills may account for the improved readings at the later evaluations.