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Meta-Analysis
. 2025 Jun;60(6):524-543.
doi: 10.1111/jre.13351. Epub 2024 Oct 28.

Effectiveness of Implant Therapy in Patients With and Without a History of Periodontitis: A Systematic Review With Meta-Analysis of Prospective Cohort Studies

Marco Annunziata  1 , Gennaro Cecoro  1 , Agostino Guida  2 , Gaetano Isola  3 , Paolo Pesce  4 , Roberto Sorrentino  5 , Massimo Del Fabbro  6   7 , Luigi Guida  1
Affiliations
Meta-Analysis

Effectiveness of Implant Therapy in Patients With and Without a History of Periodontitis: A Systematic Review With Meta-Analysis of Prospective Cohort Studies

Marco Annunziata et al. J Periodontal Res. 2025 Jun.

Abstract

Aim: This systematic review investigates the effectiveness of implant therapy in patients with and without a history of periodontitis in terms of implant loss, peri-implant marginal bone loss (MBL), and occurrence of peri-implant diseases.

Methods: The protocol of the present meta-analysis was registered on PROSPERO (CRD42021264980). An electronic search was conducted up to April 2024. All prospective cohort studies reporting implant loss, MBL, and occurrence of peri-implant diseases in both patients with a history of periodontitis (HP) and patients with no history of periodontitis (NHP) after at least 36-month follow-up were included. The risk of bias was evaluated using the Newcastle-Ottawa Scale and the quality of the evidence was also assessed. A meta-analysis was performed on the selected outcomes at the available follow-up time points. Subgroup analyses were conducted based on follow-up time, rate of progression and severity of periodontitis, and implant surface characteristics. Publication bias was evaluated using the Funnel plot and Egger's test.

Results: From 13 761 initial records, 14 studies (17 articles) were finally included. Eight studies had a low risk of bias level, and six had a medium risk of bias level. Meta-analysis showed that HP patients had a significantly greater risk for implant loss (HR: 1.75; 95% CI: 1.28-2.40; p = 0.0005; I2 = 0%), MBL (MD: 0.41 mm; 95% CI 0.19, 0.63; p = 0.0002; I2 = 54%), and peri-implantitis (3.24; 95% CI: 1.58-6.64; p = 0.001; I2 = 57%) compared to NHP, whereas no significant intergroup difference for peri-implant mucositis was found. Subgroup analyses revealed a particularly greater risk for implant loss for HP patients over a ≥ 10-year follow-up (HR: 2.02; 95% CI: 1.06-3.85; p = 0.03; I2 = 0%) and for patients with a history of grade C (formerly aggressive) periodontitis (HR: 6.16; 95% CI: 2.53-15.01; p < 0.0001; I2 = 0%). A greater risk for implant loss for stages III-IV (severe) periodontitis, and implants with rough surfaces was also found.

Conclusions: Within the limits of heterogeneous case definitions and methods of assessment, a history of periodontitis has been proved to significantly increase the risk for implant loss, particularly at long follow-up (≥ 10 years) and in case of rapidly progressive forms (grade C), and for MBL and peri-implantitis.

Keywords: dental implants; implant loss; implant survival; marginal bone loss; observational studies; periodontal diseases; peri‐implant diseases.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Overall risk of implant loss in HP versus NHP patients.
FIGURE 2
FIGURE 2
Visual representation of publication bias for the studies reporting the primary outcome event “implant loss.”
FIGURE 3
FIGURE 3
Subgroup analysis concerning the risk of implant loss in HP versus NHP patients for different follow‐up durations.
FIGURE 4
FIGURE 4
Subgroup analysis concerning implant loss risk in patients with a history of grades A–B (chronic) or grade C (aggressive) periodontitis compared to NHP patients.
FIGURE 5
FIGURE 5
Subgroup analysis concerning the risk of implant loss in HP patients receiving implants with machined/hybrid, moderately rough, and rough surfaces compared to NHP patients.
FIGURE 6
FIGURE 6
Mean difference in peri‐implant marginal bone loss between HP and NHP groups.
FIGURE 7
FIGURE 7
Risk of peri‐implant mucositis at implant level in HP versus NHP patients.
FIGURE 8
FIGURE 8
Risk of peri‐implantitis at implant level in HP versus NHP patients.
See this image and copyright information in PMC

References

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