{"id":{"repo_id":"penn","oai_identifier":"oai:repository.upenn.edu:20.500.14332/61472"},"canonical_url":"https://search.dev.ndltd.org/etd/penn/oai:repository.upenn.edu:20.500.14332/61472","repository":{"repo_id":"penn","name":"University of Pennsylvania","base_url":"https://repository.upenn.edu/server/oai/request"},"display":{"title":"The Effect of Treatment on Peri-Implant Disease Progression","abstract":"Objective To investigate the effect of treatment on peri-implant disease progression, with particular emphasis on the differential outcomes based on baseline disease severity. Materials and Methods This retrospective analysis examined 323 patients with 1003 implants treated between 2010-2024. Clinical data included probing depths, radiographic bone loss measurements, and treatment interventions. Implants were categorized as healthy, peri-implant mucositis, or peri-implantitis. Treatment modalities were classified as no treatment, non-surgical therapy, prophylaxis/maintenance, or surgical therapy. Statistical analysis employed chi-square testing and multivariate regression modeling using JMP Pro 17.1 software, with significance set at p<0.05. Mean follow-up was 7.8 years (range 0-20 years). Results The cohort comprised 47.6% females and 52.3% males with mean age 76.6±10.9 years. Progressive increases in probing depths (3.0mm to 3.6mm) and bone loss (7-10% to >25%) occurred over time regardless of maintenance status. Maintenance therapy showed no statistically significant protective effect against bone loss, with overlapping confidence intervals between maintenance and no-maintenance groups. Treatment effectiveness varied dramatically by baseline disease severity: all modalities remained stable in healthy tissues or early mucositis (≤4mm probing depths) but showed severely diminished long-term effectiveness once peri-implantitis was established (>5mm probing depths). Surgical therapy initially improved moderate cases but demonstrated progressive deterioration after 8.3 years. Advanced peri-implantitis cases (>7mm probing depths) showed limited response to all treatment approaches. Conclusion Treatment effectiveness becomes severely compromised once peri-implantitis is established, regardless of therapeutic modality. Early intervention during the mucositis phase remains crucial, as conventional treatments fail to provide sustained benefits in established peri-implantitis. These findings challenge current treatment paradigms and suggest that clinical practice should prioritize prevention and aggressive early intervention over treatment of advanced disease. The data supports a fundamental shift toward risk-based maintenance strategies focused on preventing disease progression rather than treating established peri-implantitis.","abstract_html":"Objective To investigate the effect of treatment on peri-implant disease progression, with particular emphasis on the differential outcomes based on baseline disease severity. Materials and Methods This retrospective analysis examined 323 patients with 1003 implants treated between 2010-2024. Clinical data included probing depths, radiographic bone loss measurements, and treatment interventions. Implants were categorized as healthy, peri-implant mucositis, or peri-implantitis. Treatment modalities were classified as no treatment, non-surgical therapy, prophylaxis/maintenance, or surgical therapy. Statistical analysis employed chi-square testing and multivariate regression modeling using JMP Pro 17.1 software, with significance set at p&lt;0.05. Mean follow-up was 7.8 years (range 0-20 years). Results The cohort comprised 47.6% females and 52.3% males with mean age 76.6±10.9 years. Progressive increases in probing depths (3.0mm to 3.6mm) and bone loss (7-10% to &gt;25%) occurred over time regardless of maintenance status. Maintenance therapy showed no statistically significant protective effect against bone loss, with overlapping confidence intervals between maintenance and no-maintenance groups. Treatment effectiveness varied dramatically by baseline disease severity: all modalities remained stable in healthy tissues or early mucositis (≤4mm probing depths) but showed severely diminished long-term effectiveness once peri-implantitis was established (&gt;5mm probing depths). Surgical therapy initially improved moderate cases but demonstrated progressive deterioration after 8.3 years. Advanced peri-implantitis cases (&gt;7mm probing depths) showed limited response to all treatment approaches. Conclusion Treatment effectiveness becomes severely compromised once peri-implantitis is established, regardless of therapeutic modality. Early intervention during the mucositis phase remains crucial, as conventional treatments fail to provide sustained benefits in established peri-implantitis. These findings challenge current treatment paradigms and suggest that clinical practice should prioritize prevention and aggressive early intervention over treatment of advanced disease. The data supports a fundamental shift toward risk-based maintenance strategies focused on preventing disease progression rather than treating established peri-implantitis.","abstract_has_math":false,"creators":["Dr Hazel Kerr"],"institution":null,"degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Fiorellini, Joseph"],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025","date_published":"2025","updated_at":"2026-07-24T03:46:55Z","subjects":["Dentistry"],"languages":["en"],"rights":[],"rights_urls":["https://creativecommons.org/licenses/by/4.0/"],"identifier_entries":[]},"links":{"outbound_url":"https://repository.upenn.edu/handle/20.500.14332/61472","outbound_label":"Repository record","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Fiorellini, Joseph"]},{"key":"dc:creator","label":"Author","values":["Dr Hazel Kerr"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2025-06-20T17:47:44Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2025-06-20T17:47:44Z"]},{"key":"dc:date.issued","label":"Date","values":["2025"]},{"key":"dc:type","label":"Dc Type","values":["Dissertation/Thesis"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Dentistry"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en"]},{"key":"dc:rights.uri","label":"Rights URI","values":["https://creativecommons.org/licenses/by/4.0/"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://repository.upenn.edu/handle/20.500.14332/61472"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Objective To investigate the effect of treatment on peri-implant disease progression, with particular emphasis on the differential outcomes based on baseline disease severity. Materials and Methods This retrospective analysis examined 323 patients with 1003 implants treated between 2010-2024. Clinical data included probing depths, radiographic bone loss measurements, and treatment interventions. Implants were categorized as healthy, peri-implant mucositis, or peri-implantitis. Treatment modalities were classified as no treatment, non-surgical therapy, prophylaxis/maintenance, or surgical therapy. Statistical analysis employed chi-square testing and multivariate regression modeling using JMP Pro 17.1 software, with significance set at p<0.05. Mean follow-up was 7.8 years (range 0-20 years). Results The cohort comprised 47.6% females and 52.3% males with mean age 76.6±10.9 years. Progressive increases in probing depths (3.0mm to 3.6mm) and bone loss (7-10% to >25%) occurred over time regardless of maintenance status. Maintenance therapy showed no statistically significant protective effect against bone loss, with overlapping confidence intervals between maintenance and no-maintenance groups. Treatment effectiveness varied dramatically by baseline disease severity: all modalities remained stable in healthy tissues or early mucositis (≤4mm probing depths) but showed severely diminished long-term effectiveness once peri-implantitis was established (>5mm probing depths). Surgical therapy initially improved moderate cases but demonstrated progressive deterioration after 8.3 years. Advanced peri-implantitis cases (>7mm probing depths) showed limited response to all treatment approaches. Conclusion Treatment effectiveness becomes severely compromised once peri-implantitis is established, regardless of therapeutic modality. Early intervention during the mucositis phase remains crucial, as conventional treatments fail to provide sustained benefits in established peri-implantitis. These findings challenge current treatment paradigms and suggest that clinical practice should prioritize prevention and aggressive early intervention over treatment of advanced disease. The data supports a fundamental shift toward risk-based maintenance strategies focused on preventing disease progression rather than treating established peri-implantitis."]},{"key":"dc:description.degree","label":"Dc Description Degree","values":["Master of Science in Oral Biology (MSOB)"]},{"key":"dc:title","label":"Title","values":["The Effect of Treatment on Peri-Implant Disease Progression"]}]}],"canonical_facts":{"dc:contributor.advisor":["Fiorellini, Joseph"],"dc:creator":["Dr Hazel Kerr"],"dc:date.accessioned":["2025-06-20T17:47:44Z"],"dc:date.available":["2025-06-20T17:47:44Z"],"dc:date.issued":["2025"],"dc:description.abstract":["Objective To investigate the effect of treatment on peri-implant disease progression, with particular emphasis on the differential outcomes based on baseline disease severity. Materials and Methods This retrospective analysis examined 323 patients with 1003 implants treated between 2010-2024. Clinical data included probing depths, radiographic bone loss measurements, and treatment interventions. Implants were categorized as healthy, peri-implant mucositis, or peri-implantitis. Treatment modalities were classified as no treatment, non-surgical therapy, prophylaxis/maintenance, or surgical therapy. Statistical analysis employed chi-square testing and multivariate regression modeling using JMP Pro 17.1 software, with significance set at p<0.05. Mean follow-up was 7.8 years (range 0-20 years). Results The cohort comprised 47.6% females and 52.3% males with mean age 76.6±10.9 years. Progressive increases in probing depths (3.0mm to 3.6mm) and bone loss (7-10% to >25%) occurred over time regardless of maintenance status. Maintenance therapy showed no statistically significant protective effect against bone loss, with overlapping confidence intervals between maintenance and no-maintenance groups. Treatment effectiveness varied dramatically by baseline disease severity: all modalities remained stable in healthy tissues or early mucositis (≤4mm probing depths) but showed severely diminished long-term effectiveness once peri-implantitis was established (>5mm probing depths). Surgical therapy initially improved moderate cases but demonstrated progressive deterioration after 8.3 years. Advanced peri-implantitis cases (>7mm probing depths) showed limited response to all treatment approaches. Conclusion Treatment effectiveness becomes severely compromised once peri-implantitis is established, regardless of therapeutic modality. Early intervention during the mucositis phase remains crucial, as conventional treatments fail to provide sustained benefits in established peri-implantitis. These findings challenge current treatment paradigms and suggest that clinical practice should prioritize prevention and aggressive early intervention over treatment of advanced disease. The data supports a fundamental shift toward risk-based maintenance strategies focused on preventing disease progression rather than treating established peri-implantitis."],"dc:description.degree":["Master of Science in Oral Biology (MSOB)"],"dc:identifier.uri":["https://repository.upenn.edu/handle/20.500.14332/61472"],"dc:language.iso":["en"],"dc:rights.uri":["https://creativecommons.org/licenses/by/4.0/"],"dc:subject":["Dentistry"],"dc:title":["The Effect of Treatment on Peri-Implant Disease Progression"],"dc:type":["Dissertation/Thesis"]},"updated_at":"2026-07-24T03:46:55Z"}