Systematic review of implant outcomes in treated periodontitis subjects

Objectives: To determine implant outcomes in partially dentate patients who have been treated for periodontitis compared with periodontally healthy patients. Material and Methods: All longitudinal studies (until March 2006) of endosseous dental implants of at least 6 months of loading were searched. Studies presented with one or more of the outcome measures (implant survival, success, bone-level change, peri-implantitis) were included. Screening, data abstraction and quality assessment were conducted independently and in duplicate. Results: From 4448 citations, 546 full-text papers were screened and nine studies were included. Overall, the non-periodontitis patients demonstrated better outcomes than treated periodontitis patients. However, the strength of evidence showed that the studies included were at a medium to high risk of bias, with lack of appropriate reporting and analysis of outcomes plus lack of accounting for confounders, especially smoking. Furthermore, the studies showed variability in the definitions of treated and non-periodontitis, outcome criteria and quality of supportive periodontal therapy. Meta-analysis could not be performed due to heterogeneity of the chief study characteristics. Conclusions: There is some evidence that patients treated for periodontitis may experience more implant loss and complications around implants than non-periodontitis patients. Evidence is stronger for implant survival than implant success; methodological issues limit the potential to draw robust conclusions.