Oral Abstract
5. Chrcanovic BR, Albrektsson T, Wennerberg A. Flapless vs conven-
tional flapped dental implant surgery: a meta-analysis. PLoS One.
2014;9(6):e100624.
(5:35 PM – 5:40 PM)
Does Osteoporosis Increase
Marginal Bone Loss around Dental
Implants at the Posterior of the
Maxilla?
S. Ghasemi
Abstract: Purpose: Imbalance of bone remodeling
causes osteoporosis. The aim of this study is to compare
marginal bone loss (MBL) in osteoporotic and non-osteo-
porotic patients.
Materials and Methods: This is a prospective cohort
study. Females who needed a dental implant restoration
at the posterior of the maxilla was studied. Dual-energy
X-ray absorptiometry (DXA) was performed and T score
was documented. Marginal bone loss (MBL) was
measured at 12 months after loading. Subjects were as-
signed to 2 groups: Group I (osteoporotic T score $
2.5) and Group II (T score < 2.5, non-osteoporotic).
The mean of MBL was compared between 2 groups using
an independent T test. Pearson correlation test was
applied to find any correlation between T score and MBL.
Results: Ninety females (44 in Group 1 and 46 in
Group 2) were studied. The mean of MBL was 1.20 
0.29mm in Group 1 and 0.87  0.15 in Group 2. There
was a significant difference in the mean of MBL between
2 groups (P = .001). There was a correlation between T
score and MBL (P = .001).
Conclusion: It seems MBL in osteoporotic females
was more than non-osteoporotic females. There was a
correlation between T score and MBL in the posterior
of the maxilla.
(5:40 PM – 5:45 PM)
Is Implant Placement in the
Operating Room a Risk Factor for
the Development of Peri-
Implantitis? A Retrospective
Cohort Analysis
P. Rekawek, B. Carr, W. J. Boggess, J. F. Coburn IV,
S. K. Chuang, N. Panchal
Abstract: This study aims to identify if preoperative
antibiotic administration is a protective factor for the
development of peri-implantitis in implants placed in the
operating room vs outpatient clinic. A retrospective
cohort study was conducted at the Philadelphia Veterans
Affairs Medical Center from 2006 to 2013. Physician
encounter notes within 3 months of implant placement
were used to gather data about patients’ health status,
AAOMS  2020
including the setting of implant placement in the oper-
ating room vs outpatient clinic. Operative report notes
were used to assess administration of antibiotic prophy-
laxis, recorded as none, oral, or intravenous administra-
tions. Implant status was assessed using dental
encounter notes and radiographs from follow-up appoint-
ments at 1, 3, 5, and 10 years. Peri-implantitis was defined
as radiographic evidence of changes in the crestal bone
level, clinical evidence of bleeding on probing, with or
without suppuration.1 Electronic medical records of 942
implants placed in 398 unique patients were retrospec-
tively analyzed. Descriptive statistics were computed us-
ing the SAS System (SAS Institute Version 9.4, 2002-2012,
Cary, NC). Predictor variables were implant placement
in the operating room or outpatient clinic and administra-
tion of preoperative antibiotics. The primary outcome var-
iable was the presence of peri-implantitis. Descriptive,
bivariate, and multiple logistic regression analyses were
performed to measure the association between predictive
variables and development of peri-implantitis. Of the 942
implants placed, 205 (22%) developed peri-implantitis.
Overall, placement of implants in an operating room was
shown to be associated with an increased risk in the pres-
ence of peri-implantitis (P #.0001) when compared to im-
plants placed in the outpatient clinic. When controlling
for preoperative antibiotics, patients who received im-
plants in the operating room were still found to be at
risk for developing peri-implantitis (P = .0015). The data
from this study show that implants placed in the operating
room were 4 times more likely to develop peri-implantitis
compared to implants placed in the outpatient clinic (OR
= 4.056, 95% Cl 2.697-6.102). To our knowledge, no exist-
ing literature demonstrates this significant relationship.
Our data show that preoperative antibiotics are protective
against the development of peri-implantitis in patients
who receive implants in the operating room. When con-
trolling for preoperative antibiotics, operating room pa-
tients’ risk of developing peri-implantitis decreased by
nearly 35% (OR = 2.633, 95% Cl 1.448-4.788). Studies
have demonstrated that in a peri-implantitis model, anti-
biotic-treated specimens attenuated natural bone loss.
The authors suggest that preoperative antibiotic adminis-
tration may decrease the occurrence of peri-implantitis
by reversing inflammatory responses and decreasing
attachment loss via attenuation of pathogenic oral bacteria
at the site of implant placement.2 Therefore, the adminis-
tration of preoperative antibiotics, especially in medically
complex patients who cannot tolerate implant placement
in an outpatient clinic, may temper the progression of
pathological processes around the peri-implant tissues.
Analysis of implants placed at the Philadelphia VA Medical
Center revealed an important association between the
setting of implant placement, use of preoperative antibi-
otics, and the development of peri-implantitis. Our study
shows that a standardized preoperative antibiotic regimen
can play an important role in decreasing the development
of peri-implantitis in patients who receive implants in an
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