Compliance with Supportive Periodontal Treatment in Patients with Dental Implants

Purpose: The need for dental implants is increasing, and supportive periodontal treatment can achieve long-term success and prevent peri-implantitis. Contributing factors to noncompliance with long-term scheduled supportive periodontal treatment remain unclear. To investigate whether demographic and clinical characteristics are associated with noncompliance, the authors analyzed data for patients who had received dental implants. Materials and Methods: The authors recruited patients participating in a supportive periodontal treatment program after receiving permanent prostheses on implants placed from 2005 to 2013. Demographic data and dental treatment histories were collected. Compliance was defined as a record of participation in a standard supportive periodontal treatment program for at least 1 year. The chi-square test, log-rank test, Kaplan-Meier survival curve, and Cox proportional hazards model were used for statistical analysis. Results: The study included 120 patients (259 implants, 60% compliance). The two groups (compliant and noncompliant) differed significantly in frequency distributions for sex (P = .0017), educational level (P = .0325), and histories of substance use (P = .0016), periodontitis (P = .0005), and root planing or flap surgery (P = .0002). The Kaplan-Meier survival curves and log-rank test showed that increases in cumulative continuation rates were significantly associated with male sex (P = .0025); body mass index ≥ 24 kg/m2 (P = .0093); and a history of periodontitis (P .0001), root planing or flap surgery (P .0001), and substance use (P = .0026). Multivariate Cox proportional hazards model for supportive periodontal treatment noncompliance showed significantly higher compliance in patients who had received root planing or flap surgery (hazard ratio = 0.26, 95% confidence interval = 0.12 to 0.53, P = .0002). Conclusion: These results suggest that in patients who received a permanent prosthesis on implant placement, root planing or flap surgery was the crucial factor in determining compliance with supportive periodontal treatment. However, well-designed large-scale studies with a larger sample size are needed to confirm the findings of this study. Keywords: compliance, cumulative continuation rates, implant, supportive periodontal treatment