Is History of Periodontal Disease Still a Negative Risk Indicator for Peri-implant Health Under Supportive Post-implant Treatment Coverage? A Systematic Review and Meta-analysis

Purpose: Among all previous studies, history of periodontitis (HP) has been regarded as a negative indicator for peri-implant health. However, the role of HP under regular supportive post-implant treatment (SPT) has not yet been evaluated. The aim of this review was to evaluate whether HP remains a negative indicator even under regular SPT in terms of clinical outcomes. Materials and Methods: Two independent reviewers conducted electronic and manual searches of the literature in English from January 2003 to May 2018. Human clinical studies including both patients with and without HP under SPT with more than 1-year followup and complete information about peri-implant conditions were included. Risk ratio (RR) for implant survival rate, weighted mean difference (WMD) for radiologic marginal bone loss, pocket depth, bleeding on probing, and Plaque Index were analyzed to compare the outcomes in patients with and without HP. Results: Thirteen human studies fulfilling the inclusion criteria were selected. Based on the results of meta-analyses, in implants with a rough surface, even under the regular SPT, the HP group showed a lower implant survival rate (RR: 0.96, 95% confidence interval [CI]: 0.94 to 0.98, P .001) and more radiologic marginal bone loss (WMD: 0.34 mm, 95% CI: 0.20 to 0.48, P .001), pocket depth (WMD: 0.47 mm, 95% CI: 0.19 to 0.74, P .001), and bleeding on probing (WMD: 0.08 mm, 95% CI: 0.04 to 0.11, P .001) than the non-HP group. In implants with a machined surface, HP also showed a negative effect on bone loss (WMD: 0.88 mm, 95% CI: 0.65 to 1.11, P .001). However, in implants with a machined surface, no statistical significance in survival rate was found between HP and non-HP patients (RR: 0.98, 95% CI: 0.92 to 1.04, P = .895). Conclusion: Within the limitations of this review, HP remains a negative indicator for implant survival even under regular supportive post-implant treatment coverage in rough-surfaced implants. Keywords: dental implants, history of periodontitis, meta-analysis, peri-implantitis, supportive treatment, systematic review