Is bleeding on probing a differential diagnosis between periimplant health and disease?|
Ladeira Casado, Priscila; Villas-Bôas, Ricardo; Leão da Silva, Luana Cristine; de Carvalho Andrade, Cristiana Farias; Ladeira Bonato, Letícia & Mauro Granjeiro, José
As far as the periimplant anatomy is considered, the question raised is whether or not healthy
periimplant tissues present bleeding on probing (BOP).
Aim: To assess if the criterion BOP is
strictly related to periimplant disease (PID).
Methods: 134 patients were included in this study. All
periimplant regions were clinically and radiographically evaluated. Patients were assigned to 3
groups based on radiographic and clinical aspects in the periimplant region: Group A (healthysites)
- no signs of mucosal inflammation or bone loss; Group B (mucositis) - red and swollen
mucosa, but no radiographic bone loss; Group C (periimplantitis) - radiographically confirmed
pathological bone loss. After this classification, all periimplant sulci were probed at 4 sites (mesial,
distal, buccal, lingual/palatal). Patients’ mean age was 51.7±12.4 years, 77 women and 57 men,
with a total of 486 osseointegrated endosseous implants.
Results: Groups A and C showed
significant difference in age and implant region distribution (p=0.009 and p=0.008, respectively).
After initial clinical and radiographic diagnosis of periimplant status, 33 (20.1%) regions showed
BOP in group A. All regions in Group B presented BOP. In Group C, 41 (19.9%) regions showed
no BOP. All groups differed significantly considering BOP as diagnosis parameter (p<0.0001).
Conclusions: BOP was always present in inflamed mucosa, but it was not always absent in
healthy mucosa. Not all periimplantitis regions showed BOP. Clinical and radiographic aspects
must always be considered together for diagnosis of PID, even if BOP is absent.
inflammation, periimplantitis, diagnosis