Interrelationship between Periodontitis and Peri-Implantitis: Myth or Reality?

With the evolution of treatment strategies over the years, we have come a long way from the era of removable partial dentures for edentulous ridges to implant supported superstructures in the current times. Implants have shifted from a complex and expensive option to a first line and feasible choice. So it has become the need of the hour to weigh the potential risk factors for the placement of implants. Peri-implantitis is one such factor causing the late failure of implants. Thus it is elaborated here to aid in proper treatment planning.

Periodontitis is one of the leading causes of tooth loss all over the globe. It is said to have a multifactorial etiology making it often difficult to understand and treat. After loss of teeth either partially or completely, the question arises that will the implants which replace the missing teeth also face the same fate and have peri-implantitis causing implant loss. Thus it is clinically relevant to examine the relationship between periodontitis and peri-implantitis.

This article included longitudinal studies comparing periodontal status of subjects with and without periodontitis. Screening of studies and extraction of data were carried out independently and in combination of both. Outcome measures examined were implant survival/failure, peri-implantitis, probing pocket depth and plaque index.

Most studies show conflicting results to arrive at a definitive conclusion. There are insufficient long term studies with proper controls. Some evidence points to a history of severe chronic generalized periodontitis and aggressive periodontitis causing peri-implantitis. Contrarily few studies show a successful survival of implants in subjects who have lost teeth due to periodontitis previously provided they are on a regular maintenance regimen. Thus it requires a more comprehensive research to formulate a universal protocol.