Objectives Today, implant restorations are the gold standard treatment for edentulous patients. However, short and long-term complications can also occur.
One of the most common causes of implant failure is peri-implantitis defined as an inflammatory process that affects the hard and soft supporting tissues around a functioning implant, leading to the loss of the supporting bone.
In the literature, there are several studies to determine the possible systemic and local factors associated with the onset of peri-implantitis.
The following factors were identified: poor oral hygiene, a history of periodontitis, diabetes, smoking, alcohol consumption and genetic characteristics. Few authors have instead analyzed the role that thyroid hormones could have on the onset of peri-implantitis.
The aim of this study was to evaluate the scientific literature on the influence of thyroid hormones on the onset of peri-implantitis.
Materials and methods This study analyzes and discusses the scientific literature on the relationship between thyroid hormones and peri-implantitis at 2017. A search on PubMed, Scopus and Web of Science was conducted and only four studies respected the inclusion and exclusion criteria.
Results Three studies analyzed the impact of local and systemic factors on the incidence of implants failures and identified prosthetic rehabilitations and local factors as risk indicators for peri-implantitis while systemic factors did not seem to contribute to peri-implant bone loss.
Only one study showed greater bone loss around implants in hypothyroid patients after one year of prosthetic loading compared to the control group.
This study also showed a higher incidence of soft tissue complications after the first surgical phase. This is probably because in patients with thyroid disease there is delayed wound healing due to the influence of thyroid hormones on hard and soft tissue.
Conclusions The studies analyzed also show that the correlation between thyroid diseases and peri-implant tissues are present mostly in hypothyroid patients, especially if this disease is not controlled.
Therefore, in the management of thyroid patients in implantology, it would be important to evaluate the efficacy of substitution therapy.
Because of few data present in literature it is not possible to establish whether thyroid disorders are a contraindication to implant treatment or a risk factor for implant failure.
Further studies are needed to investigate the relationship between thyroid diseases and peri-implant status.
Clinical significance Thyroid hormones play an important role in bone growth and remodeling. In cases of hypothyroidism, a decrease in bone turnover was observed, with a longer duration of the remodeling cycle, an increase in bone mass and also an increased risk of fractures as a result of greater bone rigidity.
Instead, in cases of hyperthyroidism there was an increase in bone turnover and higher stimulation of osteoblastic and osteoclastic activity with a predominance of the latter. The higher osteoclastic activity results in a reduction in bone mass and a consequent increased risk of fractures due to greater bone fragility.
The action that thyroid hormones have on bone tissue and the consequences that hypothyroidism and hyperthyroidism may have on bone metabolism may affect the peri-implant state resulting in increased bone loss.
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