{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T20:12:52Z","timestamp":1772136772727,"version":"3.50.1"},"reference-count":35,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2019,2,17]],"date-time":"2019-02-17T00:00:00Z","timestamp":1550361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: There is a need for tools that provide prediction of peri-implant disease. The purpose of this study was to validate a risk score for peri-implant disease and to assess the influence of the recall regimen in disease incidence based on a five-year retrospective cohort. Methods: Three hundred and fifty-three patients with 1238 implants were observed. A risk score was calculated from eight predictors and risk groups were established. Relative risk (RR) was estimated using logistic regression, and the c-statistic was calculated. The effect\/impact of the recall regimen (\u2264 six months; &gt; six months) on the incidence of peri-implant disease was evaluated for a subset of cases and matched controls. The RR and the proportional attributable risk (PAR) were estimated. Results: At baseline, patients fell into the following risk profiles: low-risk (n = 102, 28.9%), moderate-risk (n = 68, 19.3%), high-risk (n = 77, 21.8%), and very high-risk (n = 106, 30%). The incidence of peri-implant disease over five years was 24.1% (n = 85 patients). The RR for the risk groups was 5.52 (c-statistic = 0.858). The RR for a longer recall regimen was 1.06, corresponding to a PAR of 5.87%. Conclusions: The risk score for estimating peri-implant disease was validated and showed very good performance. Maintenance appointments of &lt; six months or &gt; six months did not influence the incidence of peri-implant disease when considering the matching of cases and controls by risk profile.<\/jats:p>","DOI":"10.3390\/jcm8020252","type":"journal-article","created":{"date-parts":[[2019,2,17]],"date-time":"2019-02-17T22:11:50Z","timestamp":1550441510000},"page":"252","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["A Peri-Implant Disease Risk Score for Patients with Dental Implants: Validation and the Influence of the Interval between Maintenance Appointments"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7084-8301","authenticated-orcid":false,"given":"Miguel","family":"de Ara\u00fajo Nobre","sequence":"first","affiliation":[{"name":"University Clinic of Stomatology, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal"},{"name":"Research and Development Department, Mal\u00f3 Clinic, 1600-042 Lisbon, Portugal"}]},{"given":"Francisco","family":"Salvado","sequence":"additional","affiliation":[{"name":"University Clinic of Stomatology, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8316-5035","authenticated-orcid":false,"given":"Paulo","family":"Nogueira","sequence":"additional","affiliation":[{"name":"Institute of Preventive Medicine, Faculty of Medicine, University of Lisbon, 1649-028 Lisboa, Portugal"}]},{"given":"Evangelista","family":"Rocha","sequence":"additional","affiliation":[{"name":"Institute of Preventive Medicine, Faculty of Medicine, University of Lisbon, 1649-028 Lisboa, Portugal"}]},{"given":"Peter","family":"Ilg","sequence":"additional","affiliation":[{"name":"Oromaxillofacial Surgery, University of Campinas, S\u00e3o Paulo 13083-970, Brasil"}]},{"given":"Paulo","family":"Mal\u00f3","sequence":"additional","affiliation":[{"name":"Implantology Department, Mal\u00f3 Clinic, 1600-042 Lisbon, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2019,2,17]]},"reference":[{"key":"ref_1","unstructured":"Lang, N.P. (1984). Consensus report of session IV. Proceedings of the First European Workshop on Periodontology, Quintessence. [1st ed.]."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S267","DOI":"10.1002\/JPER.16-0350","article-title":"Peri-implantitis","volume":"89","author":"Schwarz","year":"2018","journal-title":"J. Periodontol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jdent.2017.04.011","article-title":"Prevalences of peri-implantitis and peri-implant mucositis: Systematic review and meta-analysis","volume":"62","author":"Lee","year":"2017","journal-title":"J. Dent."},{"key":"ref_4","first-page":"1","article-title":"Attributable fractions, modifiable risk factors and risk stratification using a risk score for peri-implant pathology","volume":"34","author":"Rocha","year":"2017","journal-title":"J. Prosthodont. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1056\/NEJMp1500523","article-title":"A new initiative on precision medicine","volume":"372","author":"Collins","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1719","DOI":"10.1253\/circj.CJ-12-1177","article-title":"Simple risk algorithm to predict serious bleeding in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention","volume":"77","author":"Mrdovic","year":"2013","journal-title":"J. Circ."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Kobayashi, D., Takahashi, O., Ueda, T., Deshpande, G.A., Arioka, H., and Fukui, T. (2013). Risk factors for adverse reactions from contrast agents for computed tomography. BMC Med. Inform. Decis. Mak., 13.","DOI":"10.1186\/1472-6947-13-18"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1002\/sim.1742","article-title":"Presentation of multivariate data for clinical use: The Framingham study risk score functions","volume":"23","author":"Sullivan","year":"2004","journal-title":"Stat. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1111\/j.1600-0501.2011.02264.x","article-title":"Residual periodontal pockets are a risk indicator for peri-implantitis in patients treated for periodontitis","volume":"23","author":"Mattheos","year":"2012","journal-title":"Clin. Oral Implants Res."},{"key":"ref_10","first-page":"S32","article-title":"Clinical practice guidelines for recall and maintenance of patients with tooth-borne and implant-borne dental retorations","volume":"25","author":"Bidra","year":"2016","journal-title":"J. Prosthodont."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e12","DOI":"10.5037\/jomr.2016.7312","article-title":"The Efficacy of supportive Peri-Implant Therapies in Preventing Peri-Implantitis and Implant Loss: A Systematic Review of the Literature","volume":"7","author":"Ramanauskaite","year":"2016","journal-title":"J. Oral Maxillofac. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1177\/0022034515622432","article-title":"Impact of maintenance therapy for the prevention of peri-implant diseases: A systematic review and meta-analysis","volume":"95","author":"Monje","year":"2016","journal-title":"J. Dent. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1038\/sj.ebd.6401216","article-title":"Implant maintenance treatment and peri-implant health","volume":"18","author":"Howe","year":"2017","journal-title":"Evid. Based Dent."},{"key":"ref_14","first-page":"S16","article-title":"A systematic review of recall regimen of patients with dental restorations. Part 2: Implant-borne retorations","volume":"25","author":"Bidra","year":"2016","journal-title":"J. Prosthodont."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e501","DOI":"10.1111\/cid.12277","article-title":"Incidence of first implant failure: A retrospective study of 27 years of implant operations at one specialist clinic","volume":"17","author":"Jemt","year":"2015","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1111\/eos.12185","article-title":"Risk factors of peri-implant pathology","volume":"123","author":"Rocha","year":"2015","journal-title":"Eur. J. Oral Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/j.1399-302X.1987.tb00298.x","article-title":"The microbiota associated with successful or failing titanium implants","volume":"2","author":"Mombelli","year":"1987","journal-title":"Oral Microbiol. Immunol."},{"key":"ref_18","first-page":"242","article-title":"Attributable risk percent in case-control studies","volume":"25","author":"Cole","year":"1971","journal-title":"Br. J. Prev. Soc. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1315","DOI":"10.1097\/JTO.0b013e3181ec173d","article-title":"Receiver operating characteristic curve in diagnostic assessment","volume":"5","author":"Mandrekar","year":"2010","journal-title":"J. Thorac. Oncol."},{"key":"ref_20","first-page":"311","article-title":"Hyperbole, clinical dissonance, and scratching the surface: Complication or disease?","volume":"26","author":"Zarb","year":"2013","journal-title":"Int. J. Prosthodont."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1111\/cid.12001","article-title":"Peri-implantitis versus periodontitis: Functional differences indicated by transcriptome profiling","volume":"16","author":"Becker","year":"2014","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1177\/0022034514551754","article-title":"Composition of human peri-implantitis and periodontal lesions","volume":"93","author":"Carcuac","year":"2014","journal-title":"J. Dent. Res."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S292","DOI":"10.1111\/j.1600-051X.2008.01275.x","article-title":"Peri-implant diseases: Diagnosis and risk indicators","volume":"35","year":"2008","journal-title":"J. Clin. Periodontol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1111\/cid.12017","article-title":"Statements from the Estepona Consensus Meeting on Peri-implantitis, 2\u20134 February 2012","volume":"14","author":"Albrektsson","year":"2012","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_25","first-page":"75","article-title":"Cross-sectional study on the prevalence and risk indicators of peri-implant diseases","volume":"8","author":"Konstantinidis","year":"2018","journal-title":"Eur. J. Oral Implantol."},{"key":"ref_26","first-page":"e1271","article-title":"Peri-implant pathology: The prevalence(s) of the condition, the risk model(s) of the condition","volume":"2","author":"Rocha","year":"2016","journal-title":"Muskuloskeletal. Reg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1111\/cid.12014","article-title":"Reasons for marginal bone loss around oral implants","volume":"14","author":"Qian","year":"2012","journal-title":"Clin. Implant Dent. Relat. Res."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Trindade, R., Albrektsson, T., Tengvall, P., and Wennerberg, A. (2014). Foreign body reaction to biomaterials: On mechanisms for buildup and breakdown of osseointegration. Clin. Implant Dent. Relat. Res.","DOI":"10.1111\/cid.12274"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"144S","DOI":"10.2105\/AJPH.2004.059204","article-title":"Causation and causal inference in Epidemiology","volume":"95","author":"Rothman","year":"2005","journal-title":"Am. J. Public Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"934","DOI":"10.1111\/j.1600-0501.2012.02476.x","article-title":"Prevalence and risk factors for peri-implant disease in Belgian adults","volume":"24","author":"Marrone","year":"2013","journal-title":"Clin. Oral Implants Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1111\/clr.12944","article-title":"Frequency of peri-implant diseases and associated factors","volume":"28","author":"Gurgel","year":"2017","journal-title":"Clin. Oral Implants Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1111\/clr.12772","article-title":"Risk indicators for peri-implantitis. A cross-sectional study with 916 implants","volume":"28","author":"Dalago","year":"2017","journal-title":"Clin. Oral Implants Res."},{"key":"ref_33","first-page":"569","article-title":"Dental implant failure rates and associated risk factors","volume":"20","author":"Moy","year":"2005","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1177\/154405910208100814","article-title":"Risk factors for dental implant failure: A strategy for the analysis of clustered failure-time observations","volume":"81","author":"Chuang","year":"2002","journal-title":"J. Dent. Res."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1111\/j.1600-0501.2004.01117.x","article-title":"A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years","volume":"15","author":"Pjetursson","year":"2004","journal-title":"Clin. Oral Implants Res."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/2\/252\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:32:44Z","timestamp":1760185964000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/2\/252"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,17]]},"references-count":35,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,2]]}},"alternative-id":["jcm8020252"],"URL":"https:\/\/doi.org\/10.3390\/jcm8020252","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,17]]}}}