Sreenivas Koka: Peri-implantitis: Truths and Myths
- Animal study and ligature models: scientific models with no clinical relevance are irrelevant
- Discussion of osseosufficiency concept: net contribution of host, clinician and implant for promotion and perpetuation of osseointegration
- Scientific data review on implant surfaces, machined and moderately rough, and their influence on treatment success
- Tokyo 2014 symposium presentation
Peri-implantitis a very important topic and subject of scientific debate. In the early days of implant dentistry crestal bone loss was not common. Dr Koka discusses the concept of osseosufficiency and if implants fail or if failure of implant treatment is rather a host response to a foreign body or to an inappropriate treatment concept. In that sense the term peri-implantitis as analogy to periodontitis would be misleading. Osseosufficiency describes, when the net contribution of host, clinician and implant is sufficient to promote and perpetuate osseointegration. Implant surface design is scientifically debated as influencing factor for crestal bone loss and peri-implant tissue reaction. Dr Koka reviews commonly cited literature data and questions the clinical relevance of animal studies and ligature models for correctly describing peri-implant tissue reaction, and the behavior of current implant designs of main manufacturers. Dr Koka presents retrospective chart review data from the Mayo Clinic and concludes that TiUnite surfaces protect against higher failure risk of short implants, of implants placed in maxilla and posterior areas, and of effect of smoking.