Periodontitis as a risk factor for peri-implantitis: Systematic review and meta-analysis of observational studies

J Dent. 2018 Dec:79:1-10. doi: 10.1016/j.jdent.2018.09.010. Epub 2018 Nov 2.


Objectives: To evaluate the scientific evidence from observational studies concerning the risk of peri-implantitis development in periodontally-compromised patients.

Source: The search was carried out in Medline, via PubMed, and the Cochrane Library up to March 2018.

Study selection: Clinical studies reporting data on periodontitis and peri-implantitis, with confirmed diagnosis of peri-implantitis based on specific parameters (peri-implant probing depth and peri-implant bleeding on probing) and with evaluations of implants with at least 1 year of function were selected.

Data: Nineteen articles were included; only two did not show any association between periodontitis and peri-implantitis. Quality analysis of the articles revealed a low risk of bias in most of the studies. Meta-analyses by study design on patient data showed that patients with periodontitis had a 2.29 higher risk of peri-implantitis than patients without periodontitis (95%CI: 1.34-3.24). However, the effect estimate was OR 5.15 (95%CI: -3.35; 13.65; I2: 0%, p = 0.887) for cohort studies. A subgroup analysis showed a significant association between peri-implantitis and chronic periodontitis (patient based data: OR = 2.89, 95% CI: 1.79-4.00). Meta-analysis by study design on implant data showed that implants in individuals with periodontitis had 2.15 higher chances of having peri-implantitis (95%CI: 1.10; 3.21). However, the effect estimate was OR 3.24 (95%CI: -0.05; 6.53) for cohort studies.

Conclusions: This systematic review showed that diagnosis or history of periodontitis was associated with the occurrence of peri-implantitis. However, this association was not observed when only the cohort studies were analyzed. Results should be evaluated with caution due to heterogeneity among the included primary studies. Registration number CRD42015009518.

Clinical significance: Peri-implantitis is a prevalent condition and and present an uncertain prognosis. Determining the potential factors associated with peri-implantitis is fundamental for preventive strategies.

Keywords: Peri-implantitis; Periodontal diseases; Periodontitis; Risk factors.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Chronic Periodontitis*
  • Dental Implants*
  • Humans
  • Peri-Implantitis*
  • Risk Factors


  • Dental Implants