Incidence of Bleeding on Probing as an Indicator of Peri-Implant Disease Progression

NCT ID: NCT06033859

Last Updated: 2025-10-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ENROLLING_BY_INVITATION

Total Enrollment

150 participants

Study Classification

OBSERVATIONAL

Study Start Date

2023-09-11

Study Completion Date

2027-12-31

Brief Summary

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The primary goal of the present prospective cohort study is to evaluate the effect of varying incidences of BOP at implant sites across 15 months of maintenance visits on the probability of peri-implant disease progression. Over 15 months, participants will attend 6 visits where clinical measurements and maintenance care will be performed every 3 months.

Detailed Description

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Screening/Baseline/Maintenance Visit 1 (V1) After participants have consented, their health history will be reviewed, and their vitals including blood pressure and heart rate will be recorded. A dental exam of the teeth and gums will be completed. During this exam, a UNC 15 periodontal probe will be used to perform the clinical assessments. Intraoral photographs will be taken. An x-ray of the implant(s) included in the study will be taken using a customized x-ray holder (created during Visit 1) so that at the end of the study, a final x-ray will be taken in the exact same position. Finally, each participant will receive a dental prophylaxis (D1110) or maintenance (D4910) according to their prior periodontal diagnosis.

Maintenance Visits 2-6 (V2-V6) Participants will return in 3-month intervals at approximately 3, 6, 9, 12, and 15 months (+/- 10 days) for Study Visits V2 - V6. At each of these visits, individuals will be asked about continued participation in the study. Participants will also be asked if there have been any changes to medical or dental history and if they are taking any new medications. Intraoral photographs of the study area will be performed, as well as, collecting measurements from around the dental implant(s), and providing regular dental cleaning. At the 15 month visit, a final x-ray will be taken using the custom x-ray holder made at the first visit.

Clinical and radiographic assessments will include:

1. BOP: at each of the 4 measured locations surrounding the implant of interest will be recorded as follows:

1. Score 0 - No BOP
2. Score 1 - Bleeding dot
3. Score 2 - Continuous line of blood that fills the sulcus
4. Score 3 - Profuse bleeding and/or hemorrhage drip.
2. Probing depths (PD): at 4 locations surrounding the implant of interest (mesiolingual (ML), mesiobuccal (MB), distolingual (DL), and distobuccal (DB)). PD increase must exceed a threshold of 0.8mm to be considered progression.
3. Recession: measured at each of the 4 locations surrounding the implant of interest.
4. Keratinized mucosa width: measured at the midbuccal aspect of the implant(s).
5. Mucosal thickness: assessed with the aid of an endodontic spreader, 2mm below the mucosal margin, at the midbuccal aspect of the implant(s).
6. Marginal bone loss (MBL): measured by overlaying the baseline and final radiographs and measuring the change in marginal bone levels. Progression will have to exceed a threshold of 0.5mm to be considered.

Conditions

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Peri-Implantitis Bleeding of Subgingival Space

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Implants with BOP score 0

Implants with no BOP according to the modified bleeding index at baseline.

Clinical measurements

Intervention Type DIAGNOSTIC_TEST

With the aid of a periodontal probe, the incidence of BOP, as well as PD, recession and KM will be assessed.

Radiographic measurement

Intervention Type DIAGNOSTIC_TEST

A standardized periapical radiograph of the implant will be completed at the beginning and the end of study to determine the marginal bone loss.

Dental prophylaxis or maintenance

Intervention Type PROCEDURE

Dental prophylaxis or maintenance will be performed every 3 months.

Implants with BOP score 1

Implants with a bleeding dot at baseline.

Clinical measurements

Intervention Type DIAGNOSTIC_TEST

With the aid of a periodontal probe, the incidence of BOP, as well as PD, recession and KM will be assessed.

Radiographic measurement

Intervention Type DIAGNOSTIC_TEST

A standardized periapical radiograph of the implant will be completed at the beginning and the end of study to determine the marginal bone loss.

Dental prophylaxis or maintenance

Intervention Type PROCEDURE

Dental prophylaxis or maintenance will be performed every 3 months.

Implants with BOP score 2

Implants with a continuous line of blood that fills the sulcus at baseline.

Clinical measurements

Intervention Type DIAGNOSTIC_TEST

With the aid of a periodontal probe, the incidence of BOP, as well as PD, recession and KM will be assessed.

Radiographic measurement

Intervention Type DIAGNOSTIC_TEST

A standardized periapical radiograph of the implant will be completed at the beginning and the end of study to determine the marginal bone loss.

Dental prophylaxis or maintenance

Intervention Type PROCEDURE

Dental prophylaxis or maintenance will be performed every 3 months.

Implants with BOP score 3

Implants with a profuse bleeding and/or hemorrhage drip at baseline.

Clinical measurements

Intervention Type DIAGNOSTIC_TEST

With the aid of a periodontal probe, the incidence of BOP, as well as PD, recession and KM will be assessed.

Radiographic measurement

Intervention Type DIAGNOSTIC_TEST

A standardized periapical radiograph of the implant will be completed at the beginning and the end of study to determine the marginal bone loss.

Dental prophylaxis or maintenance

Intervention Type PROCEDURE

Dental prophylaxis or maintenance will be performed every 3 months.

Interventions

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Clinical measurements

With the aid of a periodontal probe, the incidence of BOP, as well as PD, recession and KM will be assessed.

Intervention Type DIAGNOSTIC_TEST

Radiographic measurement

A standardized periapical radiograph of the implant will be completed at the beginning and the end of study to determine the marginal bone loss.

Intervention Type DIAGNOSTIC_TEST

Dental prophylaxis or maintenance

Dental prophylaxis or maintenance will be performed every 3 months.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* adults in good general health (at least ASA 2)
* having ≥ 1 dental implant that was restored before January 2021
* patients of the University of Pittsburgh Periodontics Department
* available for maintenance visits every 3 months for the length of the study

Exclusion Criteria

* Active infectious diseases of any kind
* Pregnant or planning to become pregnant (self-reported)
* Congenital or metabolic bone disorders
* Current heavy smokers: Subjects who have smoked more than 1 pack/day within 6 months of study onset
* Co-morbid conditions that would affect the study outcome or interpretation of study results
* Require treatment for periodontal disease prior to baseline
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Pittsburgh

OTHER

Sponsor Role lead

Responsible Party

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Andrea Ravida

Assistant Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Andrea Ravida, DDS MS

Role: PRINCIPAL_INVESTIGATOR

University of Pittsburgh

Locations

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University of Pittsburgh School of Dental Medicine

Pittsburgh, Pennsylvania, United States

Site Status

Countries

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United States

Other Identifiers

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STUDY22060166

Identifier Type: -

Identifier Source: org_study_id

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