History of Periodontitis as a Risk Factor for Long-Term Survival of Dental Implants: A Meta-Analysis

Purpose: The authors conducted a meta-analysis to determine the effect of a history of periodontitis on the long-term survival of dental implants. Materials and Methods: An electronic search of PubMed and a supplemental manual search were conducted. Studies published in English through March 2013 were included in the meta-analysis. Survival rates, success rates, periodontal status, types of periodontitis, most recent follow-up time, and other information were extracted and analyzed. Results: Thirteen studies involving 2,011 patients and 6,802 implants were included in the meta-analysis. The results revealed that a history of periodontitis, especially aggressive periodontitis, is associated with significantly higher risks of long-term implant failure versus a healthy periodontium (risk ratio [RR] = 1.03, 95% confidence interval [CI] = 1.02 to 1.04). Based on the limited number of included articles, a subgroup analysis showed that a history of periodontitis had no statistically significant effect on implant survival up to 100 months of follow-up (RR = 1.03, 95% CI = 0.99 to 1.06); however, it did significantly affect implant survival within a period of 101 to 200 months (RR = 1.03, 95% CI = 1.02 to 1.04). Some implant systems also significantly influenced the correlation between a history of periodontitis and implant survival. Conclusion: Within the limitations of this meta-analysis, a history of periodontitis is estimated to be a statistical risk factor for the long-term survival of dental implants. This negative effect would be most evident in patients with aggressive periodontitis, severe periodontitis, or after a longer follow-up. Keywords: implant survival, implants, meta-analysis, periodontitis, risk factors