99 Maxillary implant overdentures: peri-implant infections were lost due to peri-implantitis. For the posterior group 19.5% of all affected implants lost more than 3 mm of marginal bone and 9.8% of all affected implants were lost (Table 6.4). Regardless of BoP-score, approximately 80% and 70% of all the implants in the anterior and posterior group, respectively, demonstrated less than -1 mm MBLC. Although this proportion remained stable between 5 and 10 years, the affected implants’ MBLC increased over time (Table 6.5). Table 6.5 | Marginal bone level change, distributed into different intervals 5 and 10 years (T5 and T10) after maxillary overdenture placement. T5 T10 Anterior Posterior Total Anterior Posterior Total Implants 227 302 529 177 224 401 MBLC Interval (mm) 0 to -1 81.9% 71.9% 76.2% 83.1% 71.4% 76.6% >-1 to -1.5 11.9% 14.2% 13.2% 6.8% 13.8% 10.7% >-1.5 to -2 4.4% 7.3% 6.1% 4.5% 4.5% 4.5% >-2 to -2.5 0.9% 3.6% 2.5% 1.7% 3.6% 2.7% >-2.5 to -3 0.9% 2.0% 1.5% 0.0% 2.3% 1.3% >-3 0.0% 1.0% 0.6% 2.3% 3.1% 2.7% Lost due to peri-implantitis 0.0% 0.0% 0.0% 1.7% 1.3% 1.5% MBLC: marginal bone level change. 6.4 DISCUSSION This study was designed to assess the incidence of peri-implantitis and peri-implant mucositis in two groups of patients with different implant systems and implant-supported maxillary overdentures. The results showed a high peri-implant mucositis incidence in both groups. The peri-implantitis incidence was low after 5 years, but increased at 10 years. Moreover, patients that were affected by peri-implantitis showed an increase in extent over time, with an increase in severity over time, while patients with less than 1 mm of bone loss remained healthy. Edentulous patients Peri-implant diseases in fully edentulous patients may differ from partially edentulous patients. The De Waal et al.25 review posed the possibility of two possible effects. On the one hand, full mouth tooth extraction may affect the quantity and quality of the periodontal microflora, thereby possibly reducing the risk of developing peri-implant diseases. On the other hand, patients eligible for full mouth tooth extraction are often associated with negative socio-behavioral factors or may have a genetic predisposition to developing periodontitis. Moreover, full edentulism increases with age and declining health. Since these factors cannot be altered, they hypothesized that fully edentulous patients may have a higher risk of developing peri-implant 6
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