Implant treatment in periodontitis-susceptible patients: a systematic review

Implant treatment in individuals with periodontitis-associated tooth loss is frequently debated. The objective of the present systematic review was to assess the principles and outcome of implant treatment in periodontitis-susceptible patients. Studies considered for inclusion were searched in MEDLINE (PubMed) and relevant journals were hand-searched. The search was restricted to studies published in English from 1980 to 2006. Prospective and retrospective cohort studies assessing implant treatment in partially and totally edentulous individuals with a history of periodontitis-associated tooth loss were included when the follow-up period was >1 year, when more than five patients were included in the study, and when the treatment involved titanium implants. The outcome measures were loss of suprastructures, loss of implants, loss of teeth, health status of peri-implant tissues and health status of periodontal tissues. Screening of eligible studies and data extraction were conducted by the reviewer. A total of 23 studies were identified. The survival rates of suprastructures and implants were high in individuals with a history of periodontitis-associated tooth loss. Therefore, implant treatment in periodontitis-susceptible patients is not contraindicated provided adequate infection control and an individualized maintenance programme. However, the higher incidence of peri-implantitis may jeopardize the longevity of the implant treatment. Consequently, further long-term prospective studies of sufficient numbers of well-characterized patients are needed before definitive conclusions can be drawn about the long-term outcome of implant treatment in periodontitis-susceptible patients.