This multicenter cross-sectional study aims to evaluate the association between access to peri-implant probing and radiographic peri-implant bone loss. Although probing is the primary diagnostic tool for peri-implant diseases, prosthetic design may limit access, potentially affecting diagnosis and disease progression. The study will include patients with dental implants in function for at least three years and will assess clinical, radiographic, and prosthetic variables.
Peri-implantitis is a plaque-induced inflammatory condition characterized by inflammation of peri-implant tissues and progressive bone loss. Probing is essential for diagnosis; however, prosthetic design may hinder or prevent proper probing access, potentially compromising diagnostic accuracy. Despite its clinical relevance, no studies have directly evaluated whether limited access to probing is associated with peri-implant bone loss. This study aims to address this gap. This is a multicenter cross-sectional observational study conducted in nine private clinics in Spain. A total of 281 patients will be included. Clinical and radiographic data will be collected, including probing accessibility, probing depth, plaque index, bleeding on probing, suppuration, prosthetic design, hygiene accessibility, and radiographic bone levels. Statistical analysis will evaluate associations between probing access and peri-implant bone loss at both patient and implant levels.
Study Type
OBSERVATIONAL
Enrollment
281
This is a non-interventional, observational cross-sectional multicenter study. No therapeutic, surgical, or pharmacological interventions are performed as part of the study. All procedures correspond to standard clinical practice and include: Peri-implant clinical examination, consisting of probing depth measurements at six sites per implant using a manual periodontal probe. When access is limited, a flexible plastic probe may be used. Assessment of probing accessibility, categorized according to the angulation and feasibility of probe insertion without prosthesis removal (possible, limited, or impossible). Recording of routine clinical parameters, including plaque presence, bleeding on probing, suppuration, and patient-reported hygiene practices. Radiographic assessment, consisting of standardized periapical radiographs obtained using a parallel technique for the evaluation of marginal bone levels. No modifications to the patients' treatment, prosthetic design, or maintenance protocol
Association between probing access and peri-implant radiographic bone loss
Evaluation of whether limited or impossible probing access is associated with increased radiographic bone loss (measured in mm from implant platform to bone level).
Time frame: Baseline (cross-sectional assessment)
Prevalence of implants with limited or no probing accessibility
Proportion of implants classified as having limited or impossible access to peri-implant probing, based on probe angulation and feasibility without prosthesis removal.
Time frame: Assessed at the baseline visit (single cross-sectional evaluation)
Prevalence of non-hygienizable implant-supported prostheses
Proportion of implant-supported restorations classified as non-hygienizable, defined as the inability to pass an interdental brush of at least 0.4 mm diameter
Time frame: Assessed at the baseline visit (single cross-sectional evaluation)
Association between hygiene accessibility and peri-implant bone loss
Evaluation of the relationship between prosthetic hygiene accessibility (hygienizable vs non-hygienizable) and radiographic peri-implant marginal bone levels.
Time frame: Assessed at the baseline visit (single cross-sectional evaluation)
Clinical peri-implant parameters
Assessment of peri-implant clinical parameters, including plaque presence, bleeding on probing, suppuration, and probing depth (when measurable), in relation to probing accessibility.
Time frame: Assessed at the baseline visit (single cross-sectional evaluation)
Patient-related and implant-related factors associated with probing accessibility
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Exploratory analysis of the association between probing accessibility and variables such as type of prosthesis (single, partial, full-arch), implant characteristics (bone level/tissue level, connection type), and patient-related factors (oral hygiene habits, maintenance frequency, history of periodontitis).
Time frame: Assessed at the baseline visit (single cross-sectional evaluation)