Vilela Nathalia, Gurgel Bruno C V, Rostant Christina M, Schey Karin C, Vekariya Krishna Mukesh, da Silva Hélio D P, Pannuti Claudio M, Duarte Poliana M
Department of Stomatology, Division of Periodontology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
Department of Dentistry, Federal University of Rio Grande do Norte, Natal, Brazil.
Clin Oral Implants Res. 2025 Mar;36(3):386-396. doi: 10.1111/clr.14390. Epub 2024 Dec 9.
This university-based retrospective study aimed to assess the performance of the implant disease risk assessment (IDRA) in predicting peri-implantitis.
Patients with implants loaded for at least 1 year were included. Peri-implantitis development was the outcome, while the IDRA score and its eight vectors were the predictors. The IDRA score was calculated using an online tool. Data were analyzed using Cox proportional hazards models and ROC curve (AUC).
Among 480 implants in 235 patients, 7.9% of implants and 9.4% of patients developed peri-implantitis. Implants at high risk for the "number of sites with PD ≥ 5 mm" vector had an increased risk (HR = 9.8, p = 0.004) of peri-implantitis, compared to those at low risk for this parameter. Implants at moderate (HR = 4.8, p = 0.04) and high (HR = 10.0, p = 0.01) risk for the "distance from the restorative margin (RM) to bone crest (BC)" vector exhibited a higher risk of peri-implantitis than implants at low risk for this parameter. The IDRA tool demonstrated an AUC of 0.66 (sensitivity = 0.80; specificity = 0.24) when estimated at implant level and an AUC of 0.61 (sensitivity = 0.91; specificity = 0.32) when calculated at patient level. The mixed-effects Cox model did not reveal a significant association between the overall IDRA score and the development of peri-implantitis (HR = 7.2, p = 0.18).
IDRA demonstrates good sensitivity but low specificity and suboptimal discriminatory capacity in predicting peri-implantitis. The "number of sites with PD ≥ 5 mm" and "distance from RM to BC" emerged as the most effective predictors for peri-implantitis.
本项基于大学的回顾性研究旨在评估种植体疾病风险评估(IDRA)在预测种植体周围炎方面的表现。
纳入种植体负重至少1年的患者。以种植体周围炎的发生情况为结局,而IDRA评分及其八个向量作为预测因素。使用在线工具计算IDRA评分。采用Cox比例风险模型和ROC曲线(AUC)分析数据。
在235例患者的480颗种植体中,7.9%的种植体和9.4%的患者发生了种植体周围炎。与“探诊深度(PD)≥5mm的位点数量”向量低风险的种植体相比,高风险种植体发生种植体周围炎的风险增加(风险比[HR]=9.8,p=0.004)。对于“修复边缘(RM)至牙槽嵴顶(BC)的距离”向量,中度风险(HR=4.8,p=0.04)和高风险(HR=10.0,p=0.01)的种植体发生种植体周围炎的风险高于该参数低风险的种植体。在种植体水平评估时,IDRA工具的AUC为0.66(敏感性=0.80;特异性=0.24),在患者水平计算时,AUC为0.61(敏感性=0.91;特异性=0.32)。混合效应Cox模型未显示总体IDRA评分与种植体周围炎的发生之间存在显著关联(HR=7.2,p=0.18)。
IDRA在预测种植体周围炎方面表现出良好的敏感性,但特异性较低且鉴别能力欠佳。“PD≥5mm的位点数量”和“RM至BC的距离”是种植体周围炎最有效的预测因素。