Risk Indicators of Long-term Outcome of Implant Therapy in Patients with a History of Severe Periodontitis or No History Of periodontitis: A Retrospective Cohort Study

Objective: The aim of this retrospective cohort study was to assess factors associated with peri-implant disease in partially edentulous patients with a history of severe periodontitis or no history of periodontitis.

Methods: Partially edentulous patients with a history of severe periodontitis/without history of periodontitis who received implant surgery within the past 6 to 8 years were recalled. Clinical and radiographic examinations were recorded. Periodontal probing depth, marginal bone loss (MBL) and peri-implantitis were considered as the primary outcome and peri-implant bleeding on probing (BOP) was considered as the secondary outcome. The following criteria were considered as the predictors, as well: history of severe periodontitis, gender, age, smoking, brushing frequency, recall interval, full-mouth plaque score, full-mouth bleeding score, splinted prosthesis, open/tight interproximal contact, width of keratinized mucosa, mucosal thickness, implants placed in the grafted bone and implant type. Univariate and multivariate regression analyses were utilized.

Results: A total of 88 patients (186 implants) fulfilled the study. Forty-seven patients (108 implants) had a history of severe periodontitis and 41 patients (78 implants) had no history of periodontitis. There was a higher chance of peri-implantitis in patients with a history of severe periodontitis (OR = 11.13; p = 0.045), implants with lack of peri-implant KM (<2 mm) and implants placed in the grafted bone (OR = 14.94, p < 0.001; OR = 4.93, p = 0.047). The risk of peri-implant MBL ≥3 mm was higher in patients with greater FMBS (OR = 1.20; p < 0.001). The chance of peri-implant BOP was independently higher in patients who brushed their teeth at most once per day (OR = 3.20; p = 0.04), higher FMBS (OR = 1.16; p < 0.001) and irregular recall visits (OR = 15.34; p = 0.001).

Conclusions: Partially edentulous patients with the history of severe periodontitis, lack of peri-implant KM and implants placed in bone-grafted sites expressed higher probability of peri-implantitis. In addition, inadequate frequency of brushing (at most once daily) and irregular recall visits were associated with greater chance of peri-implant BOP.