01 Dicembre 2020

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Correlation between thyroid hormones and peri-implantitis: state of the art

Review

Francesca De Angelis, Edoardo Brauner, Nicola Pranno, Annalisa Visca, Luigi Vito Stefanelli, Stefano Di Carlo

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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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doi: https://doi.org/10.19256/d.cadmos.10.2020.04