Risk factors for the development of inflammation in the postoperative period of dental implantation

Abstract

The aim of this work was to assess the course of the postoperative period in patients after dental implantation using the method of cytomorphometry, and to identify the possible impact of concomitant diseases of patients on the development of inflammatory complications.

Patients and methods. The study involved 90 patients with a total of 243 implants, most of them aged 39 to 65 years. Most of the patients (72 people) underwent one-stage dental implantation (193 implants), 18 people underwent two-stage implantation (50 implants). Observation time: 1, 5, 15, 25, 30, 60, 120, 180, 240 and 720 days from the moment of applying the gum shaper. Used implant brands: Dentmol Germany, Dentium Superline (Germany). All patients in the dynamics of postoperative follow-up underwent sampling smears-imprints for cytomorphometric study. The destruction index (DI) and the inflammatory-destructive index (IDI) were calculated based on the histological assessment of the cellular composition of the smears obtained.

Results. Complications of an inflammatory nature (mucositis, peri-implantitis, destruction) were detected in 11 (12.2%) patients (corresponding to the literature data), which subsequently required the removal of the implant. At all periods of observation in patients with a complicated course against the background of the development of the inflammatory process, there was a significant increase in DI and IDI in comparison with the normal course of the postoperative period. It was found that 2 people had hepatitis C as a concomitant disease, 1 had HIV, 2 had diabetes mellitus, 2 had smoking, and 1 patient refused to take antibiotics in the postoperative period. In 4 out of 11 cases, the risk factor could not be identified. There were no significant differences in the number of complications due to smoking (2 out of 43 smokers) or among non-smokers (4 out of 47), however, when analyzing the average values of DI and IDI in the group of smoking patients, higher rates were noted during the observation periods from 15 to 30 days. It has been established that in the same patient with a concomitant disease (for example, diabetes mellitus) with multiple one-stage implantation, an inflammatory process can develop in only one or several implants, and not necessarily in all.

Conclusion. The use of cytomorphometry makes it possible to diagnose the onset of an inflammatory reaction at an early stage. However, there was no convincing data on the recognition of concomitant diseases or smoking as the leading risk factors for the development of complications in the postoperative period in our study.