Diagnostic accuracy of clinical parameters to monitor periâ implant conditions: A matched caseâ control study

BackgroundThe aim of this caseâ control study was to estimate the diagnostic accuracy of the standard clinical parameters in diagnosing healthy periâ implant tissues, periâ implant mucositis, and periâ implantitis.MethodsA caseâ control study was designed to compare the clinical parameters used in the diagnosis of periâ implant diseases such as: probingdepth (PD), bleeding on probing (BOP), mucosal redness (MR), suppuration (SUP), and plaque index (PI). Furthermore, the influence of patientâ (sex, age) and implantâ related variables (implant neck configuration, time in function after loading) were evaluated to investigate the association with the clinical findings. The inferential analysis consisted of estimation by generalized estimating equations (GEE) of multilevel logistic regression models.ResultsIn total, 1,572 sites were evaluated around 262 implants from 141 patients. Sites with implant mucositis showed significant levels of BOP (ORÂ =Â 3.56), MR (ORÂ =Â 7.66) and PD (ORÂ =Â 1.48) compared to healthy sites. The specificity was 90.3% while the sensitivity was only 43.6%. Likewise, sites exhibiting periâ implantitis showed significant levels of BOP (ORÂ =Â 2.32), MR (ORÂ =Â 7.21), PD (ORÂ =Â 2.43) and SUP (ORÂ =Â 6.81) compared to healthy sites. Again, the multiple logistic regressions showed high specificity (92.1%) but modest sensitivity (52.5%). PD was the only diagnostic marker displaying significance comparing periâ implant mucositis and periâ implantitis sites (ORÂ =Â 1.76). Moreover, tissueâ level compared to boneâ level implants were less associated with SUP+ (ORÂ =Â 0.20), and PI (ORÂ =Â 0.36) and demonstrated statistical significance. In addition, age, sex, and function time significantly influenced the tested clinical parameters.ConclusionsThe diagnosis of periâ implant diseases cannot rely solely upon individual clinical parameters but rather require a combination of criteria. The clinical parameters, particularly probing depth, might accurately discern between diagnoses among periâ implant conditions. Nevertheless, the specificity of the clinical parameters surpasses the sensitivity in the detection of periâ implant diseases, validating its potential use as a diagnostic tool.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/143680/1/jper10066.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/143680/2/jper10066_am.pd