Peri-implant tissue health in reconstructed atrophic maxillae--report of 88 patients and 470 implants.

The aim of this study was to evaluate the soft-tissue health around 470 implants placed in the upper jaw of 88 patients with severe maxillary atrophy. All patients underwent a reconstruction procedure which included a composite bone grafting from the iliac crest to the maxillary sinus. Evaluation was performed at a mean implant lifetime of 21.6+/-10.9 months. The following parameters were used: probing depth, plaque-, gingival-, bleeding index and width of the buccal keratinized mucosa. They were calculated as means for each implant and related to the type of superstructure and the thickness of the original sinus floor. (higher or lower than 5 mm). A high percentage of bleeding on probing was observed in obviously clinically healthy peri-implant pockets. Bleeding on probing and deeper probing depth were especially observed in the group with severe maxillary atrophy (less than 5 mm initial height of the sinus floor.) There was a significant increase in mean peri-implant probing depth and gingiva index in overdentures versus fixed bridges. No differences were observed with respect to the width of the keratinized buccal mucosa. It was concluded that implants in the reconstructed maxilla and supporting overdentures had a higher risk for bone loss, based on the worse peri-implant tissue health observed.