Long-term outcomes by enossal implants in patients with aggressive periodontitis

Objective: The use of our two-step concept of treating periodontitis (1^st step: supra- and subgingival scaling quadrant by quadrant; 2^nd step: enhanced full-mouth root planing) leads to stable therapeutic results. It is not yet clear enough how much the existence of an edentulous arch/denture influences the long-term result. Methods: 38 patients with aggressive periodontitis and gaps awaiting prosthetic care were assigned to three test groups (group 1: ceramic enamel/Maryland bridge, n=14; group 2: enossal implant/ceramic enamel, n=12; group 3: removable denture, n=12; group 4: control group without gaps, n=15). The groups were investigated clinically and microbiologically at baseline and 6, 24 and 48 months after two-step treatment. At all three times we tested plaque index, bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment level (CAL), and took subgingival samples (4 sites). Microbiological analysis of the pooled samples was made by PCR. Results: After 6 months, clinical and microbiological parameters of all groups had improved significantly compared to the baseline data. 24 and 48 months after therapy, the groups showed significant differences in BOP and the ³ 4mm share of residual PPDs (p<0.05). At these times, the BOP levels and residual PPD shares found in groups 2 and 4 were significantly below those found in groups 1 and 3 (residual PPDs (%) in groups 2/4: 2.4/3.1 after 24 months, 1.9/2.8 after 48 months; in groups 1/3: 7.4/19.0 after 24 months, 9.5/25.9 after 48 months, p<0.05). Eradication of the key pathogens P.g. and A.a. proved most successful in groups 2 and 4 (control) after 24 and 48 months.

Conclusion: The results of the study show that the clinical and microbiological long-term success is greater in periodontitis patients with gaps to be closed by enossal implants than in patients with conventional dentures.