Skip to main content

Advertisement

SpringerLink
Log in

Effect of periodontitis history on implant success: a long-term evaluation during supportive periodontal therapy in a university setting

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

The aim of this retrospective study was to evaluate the long-term implant survival in patients with a history of chronic periodontitis, during supportive periodontal therapy (SPT), compared to periodontally healthy patients.

Materials and methods

Twenty-nine periodontitis patients (test) with SPT for ≥9 years and implant-supported restorations (≥5 years follow-up) were recruited and pair-matched with 29 periodontally healthy patients (control). Subjects in both groups were examined following active periodontal therapy and/or implantation (T1) (test 69 implants, control 76 implants) and at end of SPT or supportive postimplant therapy (T2). Differences between the groups in implant survival (primary outcome), mean marginal bone loss (MBL) and pocket probing depths (PPDs) (secondary outcomes) were evaluated.

Results

Implant survival over 5 years was 97.1% in test compared to 97.4% in control group (p = 0.562). MBL was significantly different (test 18.7 ± 18.2%; control 12.5 ± 21.3%) (p < 0.05). PPDs increased at T2 in both groups (test: T1 3.4 ± 1.0 mm; T2 4.2 ± 1.6 mm; control: T1 1.0 ± 1.2 mm; T2 2.9 ± 0.8 mm; p < 0.05 between groups). Prognostic factors for implant loss appeared to be the presence of residual periodontal pockets of ≥4 mm (OR 1.90), bone height (OR 1.81) and age (OR 1.16) at T1.

Conclusion

In terms of implant survival, no differences were observed between periodontitis and periodontally healthy patients. However, patients with history of periodontitis showed higher MBL and PPDs compared to periodontally healthy patients.

Clinical relevance

The presence of a good periodontal maintenance program with preceding successful active periodontal treatment seems to be indispensable components of successful implant treatment in patients with history of chronic periodontitis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Di Benedetto A, Gigante I, Colucci S, Grano M (2013) Periodontal disease: linking the primary inflammation to bone loss. Clinical & developmental immunology 2013:503754. doi:10.1155/2013/503754

    Article  Google Scholar 

  2. Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C (2005) The global burden of oral diseases and risks to oral health. Bull World Health Organ 83:661–669

    PubMed  PubMed Central  Google Scholar 

  3. Pjetursson BE, Helbling C, Weber HP, Matuliene G, Salvi GE, Bragger U, Schmidlin K, Zwahlen M, Lang NP (2012) Peri-implantitis susceptibility as it relates to periodontal therapy and supportive care. Clin Oral Implants Res 23:888–894. doi:10.1111/j.1600-0501.2012.02474.x

    Article  PubMed  Google Scholar 

  4. Priest G (1999) Single-tooth implants and their role in preserving remaining teeth: a 10-year survival study. Int J Oral Maxillofac Implants 14:181–188

    PubMed  Google Scholar 

  5. Ikebe K, Matsuda K, Murai S, Maeda Y, Nokubi T (2010) Validation of the Eichner index in relation to occlusal force and masticatory performance. Int J Prosthodont 23:521–524

    PubMed  Google Scholar 

  6. Graetz C, Schwendicke F, Kahl M, Dörfer CE, Sälzer S, Springer C, Schützhold S, Kocher T, König J, Rühling A (2013) Prosthetic rehabilitation of patients with history of moderate to severe periodontitis: a long-term evaluation. J Clin Periodontol 40:799–806. doi:10.1111/jcpe.12124

    Article  PubMed  Google Scholar 

  7. Chrcanovic BR, Albrektsson T, Wennerberg A (2014a) Reasons for failures of oral implants. J Oral Rehabil 41:443–476. doi:10.1111/joor.12157

    Article  PubMed  Google Scholar 

  8. Schwendicke F, Graetz C, Stolpe M, Dorfer CE (2014) Retaining or replacing molars with furcation involvement: a cost-effectiveness comparison of different strategies. J Clin Periodontol 41:1090–1097. doi:10.1111/jcpe.12315

    Article  PubMed  Google Scholar 

  9. Schwendicke F, Stolpe M, Plaumann A, Graetz C (2016) Cost-effectiveness of regular versus irregular supportive periodontal therapy or tooth removal. J Clin Periodontol. doi:10.1111/jcpe.12595

    Google Scholar 

  10. Monje A, Aranda L, Diaz KT, Alarcon MA, Bagramian RA, Wang HL, Catena A (2016) Impact of maintenance therapy for the prevention of Peri-implant diseases: a systematic review and meta-analysis. J Dent Res 95:372–379. doi:10.1177/0022034515622432

    Article  PubMed  Google Scholar 

  11. Schou S, Holmstrup P, Worthington HV, Esposito M (2006) Outcome of implant therapy in patients with previous tooth loss due to periodontitis. Clin Oral Implants Res 17(Suppl 2):104–123. doi:10.1111/j.1600-0501.2006.01347.x

    Article  PubMed  Google Scholar 

  12. Karoussis IK, Kotsovilis S, Fourmousis I (2007) A comprehensive and critical review of dental implant prognosis in periodontally compromised partially edentulous patients. Clin Oral Implants Res 18:669–679. doi:10.1111/j.1600-0501.2007.01406.x

    Article  PubMed  Google Scholar 

  13. Sousa V, Mardas N, Farias B, Petrie A, Needleman I, Spratt D, Donos N (2016) A systematic review of implant outcomes in treated periodontitis patients. Clin Oral Implants Res 27:787–844. doi:10.1111/clr.12684

    Article  PubMed  Google Scholar 

  14. Quirynen M, Abarca M, Van Assche N, Nevins M, van Steenberghe D (2007) Impact of supportive periodontal therapy and implant surface roughness on implant outcome in patients with a history of periodontitis. J Clin Periodontol 34:805–815. doi:10.1111/j.1600-051X.2007.01106.x

    Article  PubMed  Google Scholar 

  15. Chrcanovic BR, Albrektsson T, Wennerberg A (2014b) Periodontally compromised vs. periodontally healthy patients and dental implants: a systematic review and meta-analysis. J Dent 42:1509–1527. doi:10.1016/j.jdent.2014.09.013

    Article  PubMed  Google Scholar 

  16. Roccuzzo M, De Angelis N, Bonino L, Aglietta M (2010) Ten-year results of a three-arm prospective cohort study on implants in periodontally compromised patients. Part 1: implant loss and radiographic bone loss. Clin Oral Implants Res 21:490–496. doi:10.1111/j.1600-0501.2009.01886.x

    Article  PubMed  Google Scholar 

  17. Theodoridis C, Grigoriadis A, Menexes G, Vouros I (2016) Outcomes of implant therapy in patients with a history of aggressive periodontitis. A systematic review and meta-analysis Clinical oral investigations doi. doi:10.1007/s00784-016-2026-6

    Google Scholar 

  18. De Boever AL, Quirynen M, Coucke W, Theuniers G, De Boever JA (2009) Clinical and radiographic study of implant treatment outcome in periodontally susceptible and non-susceptible patients: a prospective long-term study. Clin Oral Implants Res 20:1341–1350. doi:10.1111/j.1600-0501.2009.01750.x

    Article  PubMed  Google Scholar 

  19. Ong CT, Ivanovski S, Needleman IG, Retzepi M, Moles DR, Tonetti MS, Donos N (2008) Systematic review of implant outcomes in treated periodontitis subjects. J Clin Periodontol 35:438–462. doi:10.1111/j.1600-051X.2008.01207.x

    Article  PubMed  Google Scholar 

  20. Sgolastra F, Petrucci A, Severino M, Gatto R, Monaco A (2015) Periodontitis, implant loss and peri-implantitis. A meta-analysis Clinical oral implants research 26:e8–16. doi:10.1111/clr.12319

    Article  PubMed  Google Scholar 

  21. Armitage GC (1999) Development of a classification system for periodontal diseases and conditions. Ann Periodontol 4:1–6. doi:10.1902/annals.1999.4.1.1

    Article  PubMed  Google Scholar 

  22. Graetz C, Dörfer CE, Kahl M, Kocher T, Fawzy El-Sayed K, Wiebe JF, Gomer K, Rühling A (2011) Retention of questionable and hopeless teeth in compliant patients treated for aggressive periodontitis. J Clin Periodontol 38:707–714. doi:10.1111/j.1600-051X.2011.01743.x

    Article  PubMed  Google Scholar 

  23. Graetz C, Plaumann A, Wiebe JF, Springer C, Sälzer S, Dörfer CE (2014) Periodontal probing versus radiographs for the diagnosis of furcation involvement. J Periodontol 85:1371–1379. doi:10.1902/jop.2014.130612

    Article  PubMed  Google Scholar 

  24. Frisch E, Ziebolz D, Vach K, Ratka-Kruger P (2014) Supportive post-implant therapy: patient compliance rates and impacting factors: 3-year follow-up. J Clin Periodontol 41:1007–1014. doi:10.1111/jcpe.12298

    Article  PubMed  Google Scholar 

  25. Hultin M, Komiyama A, Klinge B (2007) Supportive therapy and the longevity of dental implants: a systematic review of the literature. Clin Oral Implants Res 18(Suppl 3):50–62. doi:10.1111/j.1600-0501.2007.01447.x

    Article  PubMed  Google Scholar 

  26. Lang NP, Tonetti MS (2003) Periodontal risk assessment (PRA) for patients in supportive periodontal therapy (SPT). Oral health & preventive dentistry 1:7–16

    Google Scholar 

  27. van Winkelhoff AJ (2000) Rams TE and Slots J (1996) systemic antibiotic therapy in periodontics. Periodontology 10:45–78

    Article  Google Scholar 

  28. Levin L, Halperin-Sternfeld M (2013) Tooth preservation or implant placement: a systematic review of long-term tooth and implant survival rates. J Am Dent Assoc 144:1119–1133

    Article  PubMed  Google Scholar 

  29. Hirschfeld L, Wasserman B (1978) A long-term survey of tooth loss in 600 treated periodontal patients. J Periodontol 49:225–237

    Article  PubMed  Google Scholar 

  30. Karoussis IK, Salvi GE, Heitz-Mayfield LJ, Bragger U, Hammerle CH, Lang NP (2003) Long-term implant prognosis in patients with and without a history of chronic periodontitis: a 10-year prospective cohort study of the ITI dental implant system. Clin Oral Implants Res 14:329–339

    Article  PubMed  Google Scholar 

  31. Fardal O, Linden GJ (2008) Tooth loss and implant outcomes in patients refractory to treatment in a periodontal practice. J Clin Periodontol 35:733–738. doi:10.1111/j.1600-051X.2008.01247.x

    Article  PubMed  Google Scholar 

  32. Levin L, Ofec R, Grossmann Y, Anner R (2011) Periodontal disease as a risk for dental implant failure over time: a long-term historical cohort study. J Clin Periodontol 38:732–737. doi:10.1111/j.1600-051X.2011.01745.x

    Article  PubMed  Google Scholar 

  33. Albrektsson T, Canullo L, Cochran D, De Bruyn H (2016) “Peri-Implantitis”: a complication of a foreign body or a man-made "disease". Facts and Fiction Clinical implant dentistry and related research 18:840–849. doi:10.1111/cid.12427

    Article  PubMed  Google Scholar 

  34. Niccoli T, Partridge L (2012) Ageing as a risk factor for disease. Current biology : CB 22:R741–R752. doi:10.1016/j.cub.2012.07.024

    Article  PubMed  Google Scholar 

  35. Srinivasan M, Meyer S, Mombelli A, Muller F (2016) Dental implants in the elderly population: a systematic review and meta-analysis. Clin Oral Implants Res. doi:10.1111/clr.12898

    Google Scholar 

  36. Duval S, Jacobs DR Jr, Barber C, Lando HA, Steffen LM, Arnett DK, Luepker RV (2008) Trends in cigarette smoking: the Minnesota heart survey, 1980-1982 through 2000-2002. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 10:827–832. doi:10.1080/14622200802029517

    Article  Google Scholar 

  37. Bilano V, Gilmour S, Moffiet T, d’Espaignet ET, Stevens GA, Commar A, Tuyl F, Hudson I, Shibuya K (2015) Global trends and projections for tobacco use, 1990-2025: an analysis of smoking indicators from the WHO Comprehensive information Systems for Tobacco Control. Lancet 385:966–976. doi:10.1016/S0140-6736(15)60264-1

    Article  PubMed  Google Scholar 

  38. Collaboration NCDRF (2016) Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet 387:1513–1530. doi:10.1016/S0140-6736(16)00618-8

    Article  Google Scholar 

  39. Eke PI, Zhang X, Lu H, Wei L, Thornton-Evans G, Greenlund KJ, Holt JB, Croft JB (2016) Predicting periodontitis at state and local levels in the United States. J Dent Res 95:515–522. doi:10.1177/0022034516629112

    Article  PubMed  Google Scholar 

  40. Becker ST, Beck-Broichsitter BE, Graetz C, Dorfer CE, Wiltfang J, Hasler R (2014) Peri-implantitis versus periodontitis: functional differences indicated by transcriptome profiling. Clin Implant Dent Relat Res 16:401–411. doi:10.1111/cid.12001

    Article  PubMed  Google Scholar 

  41. Lang NP, Wilson TG, Corbet EF (2000) Biological complications with dental implants: their prevention, diagnosis and treatment. Clin Oral Implants Res 11(Suppl 1):146–155

    Article  PubMed  Google Scholar 

  42. Mombelli A, Lang NP (1998) The diagnosis and treatment of peri-implantitis. Periodontology 2000(17):63–76

    Article  Google Scholar 

  43. Mombelli A, van Oosten MA, Schurch E Jr, Land NP (1987) The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol 2:145–151

    Article  PubMed  Google Scholar 

  44. Apse P, Ellen RP, Overall CM, Zarb GA (1989) Microbiota and crevicular fluid collagenase activity in the osseointegrated dental implant sulcus: a comparison of sites in edentulous and partially edentulous patients. J Periodontal Res 24:96–105

    Article  PubMed  Google Scholar 

  45. Papaioannou W, Quirynen M, Van Steenberghe D (1996) The influence of periodontitis on the subgingival flora around implants in partially edentulous patients. Clin Oral Implants Res 7:405–409

    Article  PubMed  Google Scholar 

  46. Jemt T, Olsson M, Renouard F, Stenport V, Friberg B (2015) Early implant failures related to individual surgeons: an analysis covering 11,074 operations performed during 28 years. Clin Implant Dent Relat Res. doi:10.1111/cid.12379

    Google Scholar 

  47. Heitz-Mayfield LJ, Salvi GE, Mombelli A, Loup PJ, Heitz F, Kruger E, Lang NP (2016) Supportive peri-implant therapy following anti-infective surgical peri-implantitis treatment: 5-year survival and success. Clin Oral Implants Res. doi:10.1111/clr.12910

    PubMed  Google Scholar 

  48. Chrcanovic BR (2015) A history of periodontitis suggests a higher risk for implant loss. J Evid Based Dent Pract 15:185–186. doi:10.1016/j.jebdp.2015.10.003

    Article  PubMed  Google Scholar 

  49. Zangrando MS, Damante CA, Sant’Ana AC, Rubo de Rezende ML, Greghi SL, Chambrone L (2015) Long-term evaluation of periodontal parameters and implant outcomes in periodontally compromised patients: a systematic review. J Periodontol 86:201–221. doi:10.1902/jop.2014.140390

    Article  PubMed  Google Scholar 

  50. Mombelli A, Lang NP (1994) Clinical parameters for the evaluation of dental implants. Periodontology 2000(4):81–86

    Article  Google Scholar 

  51. König J, Plagmann HC, Rühling A, Kocher T (2002) Tooth loss and pocket probing depths in compliant periodontally treated patients: a retrospective analysis. J Clin Periodontol 29:1092–1100

    Article  PubMed  Google Scholar 

  52. Matuliene G, Pjetursson BE, Salvi GE, Schmidlin K, Bragger U, Zwahlen M, Lang NP (2008) Influence of residual pockets on progression of periodontitis and tooth loss: results after 11 years of maintenance. J Clin Periodontol 35:685–695. doi:10.1111/j.1600-051X.2008.01245.x

    Article  PubMed  Google Scholar 

  53. Fransson C, Lekholm U, Jemt T, Berglundh T (2005) Prevalence of subjects with progressive bone loss at implants. Clin Oral Implants Res 16:440–446. doi:10.1111/j.1600-0501.2005.01137.x

    Article  PubMed  Google Scholar 

  54. Roccuzzo M, Bonino L, Dalmasso P, Aglietta M (2014) Long-term results of a three arms prospective cohort study on implants in periodontally compromised patients: 10-year data around sandblasted and acid-etched (SLA) surface. Clin Oral Implants Res 25:1105–1112. doi:10.1111/clr.12227

    Article  PubMed  Google Scholar 

  55. Sanz M, Chapple IL (2012) Clinical research on peri-implant diseases: consensus report of working group 4. J Clin Periodontol 39(Suppl 12):202–206. doi:10.1111/j.1600-051X.2011.01837.x

    Article  PubMed  Google Scholar 

  56. Rasperini G, Siciliano VI, Cafiero C, Salvi GE, Blasi A, Aglietta M (2014) Crestal bone changes at teeth and implants in periodontally healthy and periodontally compromised patients. A 10-year comparative case-series study. J Periodontol 85:e152–e159. doi:10.1902/jop.2013.130415

    Article  PubMed  Google Scholar 

  57. Rammelsberg P, Lorenzo-Bermejo J, Kappel S (2016) Effect of prosthetic restoration on implant survival and success. Clin Oral Implants Res. doi:10.1111/clr.12974

    Google Scholar 

  58. Messias A, Tondela JP, Rocha S, Reis R, Nicolau P, Guerra F (2013) Acrylic customized X-ray positioning stent for prospective bone level analysis in long-term clinical implant studies. Open Journal of Radiology 03:136–142

    Article  Google Scholar 

  59. Meijer HJ, Steen WH, Bosman F (1993) A comparison of methods to assess marginal bone height around endosseous implants. J Clin Periodontol 20:250–253

    Article  PubMed  Google Scholar 

  60. Coli P, Christiaens V (2000) Sennerby L and Bruyn H (2017) reliability of periodontal diagnostic tools for monitoring peri-implant health and disease. Periodontology 73:203–217. doi:10.1111/prd.12162

    Article  Google Scholar 

  61. Renvert S, Polyzois I, Claffey N (2011) How do implant surface characteristics influence peri-implant disease? J Clin Periodontol 38(Suppl 11):214–222. doi:10.1111/j.1600-051X.2010.01661.x

    Article  PubMed  Google Scholar 

  62. Lang NP, Berglundh T (2011) Periimplant diseases: where are we now?—consensus of the seventh European workshop on Periodontology. J Clin Periodontol 38(Suppl 11):178–181. doi:10.1111/j.1600-051X.2010.01674.x

    Article  PubMed  Google Scholar 

  63. Uribarri A, Bilbao E, Marichalar-Mendia X, Martinez-Conde R, Aguirre JM, Verdugo F (2016) Bone remodeling around implants placed in augmented sinuses in patients with and without history of periodontitis. Clin Implant Dent Relat Res. doi:10.1111/cid.12450

    PubMed  Google Scholar 

  64. Matarasso S, Rasperini G, Iorio Siciliano V, Salvi GE, Lang NP, Aglietta M (2010) A 10-year retrospective analysis of radiographic bone-level changes of implants supporting single-unit crowns in periodontally compromised vs. periodontally healthy patients. Clin Oral Implants Res 21:898–903. doi:10.1111/j.1600-0501.2010.01945.x

    PubMed  Google Scholar 

Download references

Acknowledgements

The authors are grateful to all colleagues in both departments, who treated the investigated patients over the last 30 years.

Author information

Authors and Affiliations

  1. Clinic of Conservative Dentistry and Periodontology, University of Kiel, Kiel, Germany

    Christian Graetz, Karim Fawzy El-Sayed, Antje Geiken, Anna Plaumann, Sonja Sälzer & Christof E. Dörfer

  2. Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Cairo University, Giza, Egypt

    Karim Fawzy El-Sayed

  3. Department of Oral and Maxillofacial Surgery, University of Kiel, Kiel, Germany

    Eleonore Behrens & Jörg Wiltfang

Authors
  1. Christian Graetz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Karim Fawzy El-Sayed
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Antje Geiken
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Anna Plaumann
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sonja Sälzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Eleonore Behrens
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Jörg Wiltfang
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Christof E. Dörfer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christian Graetz.

Ethics declarations

Conflict of interest

Author Christian Graetz declares that he has no conflict of interest. Author Karim Fawzy El-Sayed declares that he has no conflict of interest. Author Antje Geiken declares that she has no conflict of interest. Author Anna Plaumann declares that she has no conflict of interest. Author Sonja Sälzer declares that she has no conflict of interest. Author Eleonore Behrens declares that she has no conflict of interest. Author Jörg Wiltfang declares that he has no conflict of interest. Author Christof E. Dörfer declares that he has no conflict of interest.

Funding

This study was self-funded by the authors and supported by their institutions Clinic of Conservative Dentistry and Periodontology as well as the Department of Oral and Maxillofacial Surgery, both University of Kiel, Germany.

Ethical approval

All procedures performed in the current study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The local Ethical Committee approved the study’s protocol (Kiel: D442/10 and D489/13).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Electronic supplementary material

Figure S1

Distribution and number of implants in test and control group at T1 (implant insertion) according the jaw (upper/lower) and side (left/right). (JPEG 449 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Graetz, C., El-Sayed, K.F., Geiken, A. et al. Effect of periodontitis history on implant success: a long-term evaluation during supportive periodontal therapy in a university setting. Clin Oral Invest 22, 235–244 (2018). https://doi.org/10.1007/s00784-017-2104-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-017-2104-4

Keywords

Search

Navigation