Research J. Pharm. and Tech.

9(9): September 2016

ISSN

0974-3618 (Print)
0974-360X (Online)

www.rjptonline.org

RESEARCH ARTICLE

Health of gingiva in patients post dental implant therapy- A Cross sectional

study
Mohamad Qulam Zaki Bin Mohamad Rasidi
Saveetha Dental College, Saveetha University, Poonamalle High Road, Chennai -600077India.
*Corresponding Author E-mail: zaki.qulam24@gmail.com

ABSTRACT:
Aim and objectives: The aim of this study is to evaluate the patients' gingival health around oral implants. This
helps in assessing patients oral hygiene and also motivates the dental implant practitioner to plan a short module
to educate the patients on their dental hygiene at a personalized level.
Materials and Methods: 40 patients, both male and female were viewed and assessed for their gingival health
post implant therapy at the Department of Oral Implantology, Saveetha Dental College and Hospital, Chennai,
Tamil Nadu, India during the year of 2015. From the total number of patients viewed, 11 male patients were
assessed after 1 year of implant therapy, 18 male patients after 2 year of implant therapy, 6 female patients after
1 year implant therapy and 5 female patients after 2 years of therapy. The mean age of male and female patients
are 45 years and 50 years respectively. An autoclavable plastic probe was used to check the gingival condition.
The Mombelli Indices were used to assess the marginal mucosal condition.
Results: 39 patients including showed Mombelli score of 0. However, only one male patient showed Mombelli
score of 1. No score of 2 and 3 were observed during first and second years of follow-up.
Conclusion: About 97.4% of all patients were found to maintain good gingival health (Mombelli score of 0)
around dental implants in the first two years after treatment. Further evaluation are required to determine the
gingival status after longer durations.

KEYWORDS: health; Post-dental Implant; Marginal Mucosa; Patients Behavioral

INTRODUCTION:
The patients maintenance of dental implants post
treatment plays an important role in its survival rate. [15]
Determination of the patients gingival health changes
help in controlling the harmful effects of plaque
accumulation by incorporation of patient education or
motivation into dental practice.[16]

Dental implant treatment has been used as a gold

standard for the replacement of missing tooth for over
the past few decades.[1] [2] Since its first use around the
year 1940s,[3, 4] there has been immense advancements
in the design and surface characteristics of dental
implants. The long term studies showing high survival
rates of dental implants [5-7] coupled with increased
patient awareness over the years [8-11] has also
contributed in the increased market share of many dental
implant systems. [12-14]
Received on 31.03.2016
Accepted on 20.05.2016

Long term evaluation of dental implants are very

important in order to assess its survival as well as the
rates of complication or failure. [17, 18] This also helps
in the determination of factors affecting the success and
to identify the specific problems faced by the patients.
[17, 19]

Modified on 22.04.2016
RJPT All right reserved

Research J. Pharm. and Tech 2016; 9(9):

DOI:

Research J. Pharm. and Tech. 9(9): September 2016

In the First European Workshop on Periodontology in

Ittingen, Switzerland in 1993, the phrase peri-implant
disease, peri-implant mucositis and peri-implantatis were
given the scientific meaning. [20-22] Peri-implant
disease is a collective term for inflammatory processes
in the tissues surrounding an implant.[23] Peri-implant
mucositis was defined as a reversible inflammatory
process in the soft tissues surrounding a functioning
implant, whereas peri-implantitis is an inflammatory
process additionally characterized by loss of peri-implant
bone. [21]

OBSERVATION AND RESULTS:

There are many methods to determine gingival health

around teeth such as Gingival Index [24-26], Plaque
Index [26] and others. Mombelli indices are used to
assess the marginal mucosal condition around the oral
implants.[21] [27] Assessment of Mombelli indices
clinical signs has been considered important in the
diagnosis of several periodontic disease. [28] It is
generally recommended that the patients who had
undergone the implant treatment are reviewed at yearly
intervals. [29] The gingival index is measured based on
the observation of oral implant area.

In this study, most of the patients (39 patients including

male and female patients) have shown Mombelli score 0
which mean that no bleeding when a periodontal probe is
passed along the mucosal margin adjacent to the implant.
However, only one male patient showed Mombelli score
1 which indicates that isolated bleeding spots were
visible. There are no score 2 and 3 shown in the
observation for first and second years follow-ups. Table
2 and Figue 1 showing the number of patients, male and
female, and their marginal mucosa condition after
follow-ups period based on Mombelli score.

40 patients, both male and female were assessed for their

gingival health post dental implant treatment at Oral
Implantology clinic, Saveetha Dental College and
Hospital, Chennai, Tamil Nadu, India during the year of
2015. Of the total of number patients, 11 male patients
are assessed after 1 year of implant therapy, 18 male
patients after 2 year of implant therapy, 6 female patients
after 1 year implant therapy and 5 female patients after 2
years of therapy. The mean age of the patients were 45
years and 50 years for men and female respectively.

This study aims to determine the gingival health of Table 2: The number of patients,
patients around dental implants. This helps in assessing Marginal mucosa condition after
score
the patients oral hygiene status and thus helps the Mombelli
Mombelli score
practitioner to formulate a module to educate them.
Male, follow-ups after 1 year
Male, follow-ups after 2 year
Female, follow-ups after 1 year
Female, follow-ups after 2 year

MATERIALS AND METHODS:

Male and Female, and their

follow-ups period based on
0
10
18
6
5

1
1
0
0
0

2
0
0
0
0

3
0
0
0
0

40 patients, both males and females were assessed for

their gingival health post dental implant treatment at
Oral Implantology department of Saveetha Dental DISCUSSION:
In this study, 39 patients including male and female
College and Hospital, Chennai, India during the year
patients which are age range between 20 years old to 73
2015.
years old are taken as the study subject. The correlation
between the Mombelli score of mucosa condition and
An autoclavable plastic probe was used to check the
their dental hygiene after implant therapy are taken into
gingival health. Apart from the redness and swelling of
consideration in result and conclusion of this study.
the marginal tissues, bleeding on probe (BOP) can also
be a result from peri-implant infections. BOP was
The present study on the Mombelli score of mucosa
notated as BOP+ in clinical record elicited after a probe
condition in the male and female patients indicates that
insertion into the sulcus by using light pressure
approximately most of them scoring 0 which mean no
approximately 0.25 N. The absence of bleeding on
bleeding when a periodontal probe is passed along the
probing is marked as BOP-.
mucosal margin adjacent to the implant. However, one
male patient during his first year follow-up give score of
Mombelli Indices are used to assess the marginal
1 which mean isolated bleeding spots visible.
mucosal condition. These scores are mentioned in table
1.
Table 1: Indices for Marginal mucosa conditions around oral From the result, 97.4% of patients did a correct dental
hygiene suggested by dentist after their implant therapy.
Implants [4]
Score
Mombelli (Mpi)
Only 2.6% of patients did not cope with the correct
0
No bleeding when a periodontal probe is passed along
dental hygiene. Overall data indicates all females
the mucosal margin adjacent to the implant
patients have excellent dental hygiene after their therapy
1
Isolated bleeding spots visible
meanwhile there have small percentage of 0.03% of
2
Blood forms a confluent red line on mucosal margin
male patients got score 1.
3
Heavy or profuse bleeding

Research J. Pharm. and Tech. 9(9): September 2016

The result indicates that even more patients are having

better awareness on their dental hygiene, however there
are still some group of patients that still do not know
how to maintain their dental hygiene after the treatment.
There some guidelines needed by dental implant
practitioner to plan the module for education purposes on
patients dental hygiene. A new physiological patients
environment can be built through the module.

can be raising by educating the patients on choosing the

correct products that will help them in maintaining their
dental health and hygienic after therapy.

There are three components in the motivational stage

which are strategy, principle and spirit.[31] In a
strategy component, a dentist should suggest a good
motivation based on their gender, occupation and
obstacle that they might have after their implant therapy.
Based on the result in this study, male patient have less
awareness on their dental hygiene due to some factors
that practitioner might be do not know. Therefore,
history taking procedure is very important before
assessing a motivation. [32]

In the preparatory change talk, the elements needed to be

reached are DARN which are Desire (I want to change),
Ability (I can change), Reason (It is important to
change), and Need (I should change).

In a principle component, there 4 different things that

should be hold by dental implant practitioner during their
motivational stages which are express empathy, support
self-efficacy, roll with resistance and develop
discrepancy.

CONCLUSION:

Support change
A dental implant practitioner can support a patient
change by encouraging a patient problem solving,
offering a set of strategies of options and help in
planning steps for the change. Support change can be
aided by change talk between the practitioner and
Assess motive
A dental implant practitioner need to provide some patients which are consisting 3 stages.
motivation for their patients after the treatment. This can
be done by a motivational interviewing. Motivational First stage is Elicit-Provide-Elicit stage. Second stage
interviewing is a client-centred, directive method for is roll with resistance and third stage is a brief
enhancing intrinsic motivation to change by exploring intervention. The change talk between patients and
and resolving ambivalence (Rollnick and Miller 1991). implant practitioner should consists of preparatory
[30]
change talk and implementing change talk.

In the implementing change talk, the elements needed to

achieve are CAT which are Commitment (I will make
changes), Activation (I am ready, prepared, willing to
change) and Taking Steps (I am taking specific actions
to change). [34]

The maintenance and condition of dental implants post

treatment plays an important role in survival rate and
controlling the harmful effects. The study of mucosa
condition after post implant therapy can help the dental
practitioner to build new physiological environment in
order to educate and motivate the patients on their dental
hygiene. Based on recent study, 97.4% of patients did a
correct dental hygiene suggested by their dental
practitioner after their implant therapy. Only 2.6% of
patients did not cope with the correct dental hygiene and
overall data indicates that all female patients have
excellent dental hygiene compared to male. The module
that suggested by writer are assess motive, raise
awareness and support change to the patients after their
implant treatment.

Meanwhile in a spirit component, is also known as

clinical way of being. The spirit is based on 3 element
which are collaboration between the dental practitioner
and the patients, evoking or drawing out the patients
ideas about change and the autonomy emphasizing of the
patients.

Raise awareness
A dental practitioner always confused between raise
awareness and giving information to the patients. Based
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