Distinguishing predictive profiles for patient-based risk assessment and diagnostics of plaque induced, surgically and prosthetically triggered peri-implantitis

Objective: To investigate whether specific predictive profiles for patient-based risk assessment/diagnostics can be applied in different subtypes of peri-implantitis.Materials and methods: This study included patients with at least two implants (one or morepresenting signs of peri-implantitis). Anamnestic, clinical, and implant-related parameters werecollected and scored into a single database. Dental implant was chosen as the unit of analysis, anda complete screening protocol was established. The implants affected by peri-implantitis were thenclustered into three subtypes in relation to the identified triggering factor: purely plaque-inducedor prosthetically or surgically triggered peri-implantitis. Statistical analyses were performed tocompare the characteristics and risk factors between peri-implantitis and healthy implants, as wellas to compare clinical parameters and distribution of risk factors between plaque, prostheticallyand surgically triggered peri-implantitis. The predictive profiles for subtypes of peri-implantitiswere estimated using data mining tools including regression methods and C4.5 decision trees.Results: A total of 926 patients previously treated with 2812 dental implants were screened foreligibility. Fifty-six patients (6.04%) with 332 implants (4.44%) met the study criteria. Data from125 peri-implantitis and 207 healthy implants were therefore analyzed and included in thestatistical analysis. Within peri-implantitis group, 51 were classified as surgically triggered (40.8%),38 as prosthetically triggered (30.4%), and 36 as plaque-induced (28.8%) peri-implantitis. For periimplantitis, 51 were associated with surgical risk factor (40.8%), 38 with prosthetic risk factor(30.4%), 36 with purely plaque-induced risk factor (28.8%). The variables identified as predictors ofperi-implantitis were female sex (OR = 1.60), malpositioning (OR = 48.2), overloading (OR = 18.70),and bone reconstruction (OR = 2.35). The predictive model showed 82.35% of accuracy andidentified distinguishing predictive profiles for plaque, prosthetically and surgically triggered periimplantitis. The model was in accordance with the results of risk analysis being the externalvalidation for model accuracy.Conclusions: It can be concluded that plaque induced and prosthetically and surgically triggeredperi-implantitis are different entities associated with distinguishing predictive profiles; hence, theappropriate causal treatment approach remains necessary. The advanced data mining modeldeveloped in this study seems to be a promising tool for diagnostics of peri-implantitis subtypes.