Periodontitis, implant loss and peri-implantitis. A meta-analysis.

OBJECTIVE: The aim of the present systematic review and meta-analysis was to assess the role of periodontal disease as a risk factor for implant loss, peri-implantitis and implant-bone loss. MATERIALS AND METHODS: Six electronic database and a manual search resulted in 7391 unique publications; after selection only 16 studies were included in systematic review. Dichotomous data were expressed as risk ratio (RR) and 95% confidence interval (CI), while continuous data were expressed as standardized mean difference (SMD). Due to the expected inter-study heterogeneity, a random effect model was used for both type of data. The pooled effect was considered significant for a P < 0.05. RESULTS: Meta-analysis revealed that an higher and significant risk for implant loss was present in patients affected by PD (RR: 1.69, 95% CI: 1.31-2.17, P < 0.0001). A higher and significant IBL was present in patients with periodontal disease, when compared with patients periodontally healthy (SMD: 0.38, 95% CI: 0.18-0.58, P = 0.0002). Patients periodontally compromised showed an increased risk of PI, when compared with patients without periodontitis (RR: 2.17, 95% CI: 1.51-3.12, P < 0.0001) No evidence of significant heterogeneity was detected for the three outcomes. CONCLUSION: Strong evidence suggests that periodontitis is a risk factor for implant loss; moderate evidence revealed that periodontitis is a risk factor for peri-implantitis and that patients with periodontitis have higher implant-bone loss.