Effect of Emergence Angle on Peri-implant Status (EEAPS)

The Effect of Implant Prosthesis Emergence Angle on Peri-Implant Health and Disease

The study was conducted at the Division of Periodontology, Bolu Abant İzzet Baysal University Faculty of Dentistry. Participants were systemically healthy individuals aged 18 to 70 who had received dental implant prostheses within the past five years and had high-quality panoramic radiographs. The peri-implant status of the subjects was evaluated using various indices and radiographic analyses in accordance with Chicago's Classification of Periodontal and Peri-Implant Diseases and Conditions. Additionally, measurements of gingival thickness, gingival phenotype, keratinized gingival width, and emergence angle were performed.

Study Overview

• Status: Completed
• Conditions: Peri-Implantitis; Peri-implant Mucositis; Peri-implant Health
• Intervention / Treatment: Other: emergence profile

Detailed Description

Patient histories were collected from those who met the study criteria, and panoramic radiographs were taken. A total of 310 implants were initially assessed, and 192 implants were selected for inclusion in the study. All implant patients underwent an evaluation of plaque index , gingival index, bleeding on probing , pocket depth, clinical attachment level, and gingival recession. The peri-implant condition was determined using these indices and radiographs, in accordance with the guidelines from the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions and the 2023 European Federation of Periodontology. Patients were categorized into three groups: peri-implantitis (64), peri-implant health (64), and peri-implant mucositis (64). Additionally, gingival thickness (GT), keratinized gingival width (KGW), and gingival phenotype (GP) around the implants were measured, and the emergence angle (EA) of the implants was calculated.

• Study Type: Observational
• Enrollment (Actual): 192

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Bolu, Turkey (Türkiye), 14030
    • Bolu Abant Izzet Baysal University, Dentistry Faculty

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Patients who have received implants

Description

Inclusion Criteria:

• Systemically healthy individuals or individuals with controlled medical conditions
• Availability of high-quality panoramic radiographs that could be accurately measured after fabrication of the dental implant prosthesis
• Implants placed no more than five years prior to evaluation

Exclusion Criteria:

• Individuals with uncontrolled systemic diseases
• Presence of habitual bruxism
• Current smokers
• Pregnant or breastfeeding individuals
• Use of anti-inflammatory or immunosuppressive medications affecting the mucosa or bone
• Individuals who had received treatment for peri-implant disease after implant placement
• Development of peri-implantitis due to residual cement or prosthesis design, or improperly positioned implants

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Peri-implantitis; Peri-implantitis patients are those who have developed inflammation around a dental implant, leading to the loss of supporting bone and the presence of pockets of infection.	Other: emergence profile; The emergence angles of the implants were measured on panoramic radiographs.
Peri-implant mucositis; Peri-implant mucositis refers to a reversible inflammatory condition affecting the soft tissues surrounding a dental implant, characterized by redness, swelling, and bleeding on probing, without any bone loss.	Other: emergence profile; The emergence angles of the implants were measured on panoramic radiographs.
Peri-implant health; Peri-implant health refers to the condition where the tissues surrounding a dental implant are free from inflammation, with no signs of redness, swelling, bleeding on probing, or bone loss, indicating a stable and healthy implant environment.	Other: emergence profile; The emergence angles of the implants were measured on panoramic radiographs.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Emergence angle	EA was determined by measuring the angle formed between the long axis of the implant and a tangent line drawn to the restoration. A line was initially drawn along the long axis of the implant at its outside collar. Subsequently, a second line, tangent to the restoration, was drawn from the platform. The angle at which the junction occurred was recorded as the EA .	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
periodontal pocket depth	The periodontal pocket depth is the measurement of the distance between the gingival margin and the most coronal region of the junctional epithelium.	Baseline
bleeding on probing	The bleeding on probing index was established as the occurrence of bleeding in the sulcus, thirty seconds after measuring the depth of the periodontal pockets in all dental implant.	Baseline
plaque index	an index for estimating the status of oral hygiene by measuring dental plaque that occurs in the areas adjacent to the gingival margin. 0 is minimum and 3 is maximum. The situation worsens as the score increases.	Baseline
gingival index	The Gingival Index (GI) scores each site on a 0 to 3 scale, with 0 being normal and 3 being severe inflammation characterized by edema, redness, swelling, and spontaneous bleeding. 0 is minimum and 3 is maximum.	Baseline
clinical attachment level	The peri-implant clinical attachment level is determined by measuring the distance from the implant margin to the base of the mucosal sulcus using a Williams periodontal probe.	Baseline
Gingival recession	Gingival recession is the measured distance between the enamel-cementum and the gingival margin. Assessment was performed using a Williams periodontal probe.	Baseline
gingival thickness	GT was measured by inserting a number eight canal file from the buccal side of the implant until it reached the alveolar bone and then securing it with a stopper to determine the distance.	Baseline
keratinized tissue width	The width of the keratinized gingiva was measured via a periodontal probe from the mucogingival margin to the gingival margin.	Baseline

Collaborators and Investigators

• Sponsor: Abant Izzet Baysal University
• Investigators: Principal Investigator: Tuğba Şahin, Bolu Abant İzzet Baysal Üniversity

Study record dates

Study Major Dates

• Study Start (Actual): September 7, 2024
• Primary Completion (Actual): April 30, 2025
• Study Completion (Actual): May 1, 2025

Study Registration Dates

• First Submitted: November 18, 2025
• First Submitted That Met QC Criteria: December 8, 2025
• First Posted (Actual): December 22, 2025

Study Record Updates

• Last Update Posted (Actual): December 22, 2025
• Last Update Submitted That Met QC Criteria: December 8, 2025
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Keywords: Dental implants; Peri-implantitis; Peri-implant tissue; Emergence angle
• Additional Relevant MeSH Terms: Periodontal Diseases; Mouth Diseases; Stomatognathic Diseases; Peri-Implantitis
• Other Study ID Numbers: AIBU-DH-TS-04

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No