Peri-implantitis associated with actinomycosis around failing implants: A Clinico-pathological study

Aim: Peri-implantitis may cause implant failure. The aim of this study is to correlate the clinical and radiographic findings to the histopathological analysis in peri-implantitis of failing and/or ailing implants. Methods: This study includes 33 patients (12 men and 21 women, mean age 57.5 years, age range 21.4-75.4 years) with a total of 413 implants, implanted between 1993-2010. Patients fulfilled two criteria: 1) patients were diagnosed with at least one failing and/or ailing implant, and 2) at least one biopsy of each patient was performed and histopathologically evaluated (46 biopsies in total). A total of 305 implants were implanted at Schwartz-Arad Day-Care Surgical Center and 108 were implanted in other clinics but were treated at the center later on. Data regarding patient health and smoking habits, bone resorption, implant type and other surgical procedures performed (e.g. Augmentation of implant defect) was collected as well. Result: Out of 413 implants included in this study, 72% survived, 22% failed, and 6% were diagnosed as ailing. Histopathological diagnosis was obtained for 46 out of 114 failing and/or ailing implants and confirmed non-specific inflammatory reaction in all biopsies, and actinomycosis in 26% of the biopsies. There were no significant differences in the clinical and radiographic features between implants with or without associated actinomycosis. An equivalent percentage of failing implants was diagnosed when peri-implantitis presented with or without actinomycosis. Conclusion: The presence of actinomycosis at advanced stages of peri-implantitis did not seem to be associated with a worse outcome compared to those without actinomycosis