Dental implant placement is increasingly common and poorer outcomes have been reported in patients with prior periodontal disease.
The aim of this review was to assess the outcomes of implant therapy in partially dentate patients treated for aggressive periodontitis (GAgP) in comparison to periodontally healthy (HP) and patients treated for chronic periodontitis (CP)
Methods
Searches were conducted in the Medline Embase, Cochrane Oral Health Group’s Trial Register and the Cochrane Central Register of Controlled Trials databases . This was supplemented by hand searching of the journals; British Journal of Oral and Maxillofacial surgery, Clinical Implant Dentistry and Related Research, Clinical Oral Implants Research, European Journal of Oral Implantology, Implant Dentistry, International Journal of Oral and Maxillofacial Implants, International Journal of Oral and Maxillofacial Surgery, International Journal of Periodontics and Restorative Dentistry, International Journal of Prosthodontics, Journal of Clinical Periodontology, Journal of Dental Research, Journal of Oral Implantology, Journal of Oral and Maxillofacial Surgery, Journal of Periodontology, and Journal of Prosthetic Dentistry.
Randomised clinical trials (RCTs), controlled clinical trials (CCTs), cohort studies, prospective case control studies reporting on clinical survival/success, and radiographic outcomes in endosseous dental implants in partially dentate patients with a history of aggressive/ early-onset/refractory/recalcitrant periodontitis were considered. The primary outcomes were marginal bone loss (MBL) and cumulative survival rates. Two reviewers independently selected studies with study quality being assessed using the Newcastle-Ottawa Scale (NOS) and a random effects meta-analysis was conducted.
Results
- 7 prospective cohort studies involving 343 patients (1013 implants) were included
- The observation period varied between 3 and 16 years.
- The 3-year survival rate in patients with aggressive periodontitis is statistically significantly lower (97.98 %) in comparison to periodontally healthy and subjects with a history of chronic periodontitis (100%).
| Health patients | Chronic periodontitis | Aggressive periodontitis | |
| 3 yr. Survival rate | 100% | 100% | 97.98 % |
| 3-year mean marginal bone loss | 0.69 mm
(95%CI 0.31- 1.19) |
0.47 mm
(95%CI 0.19 -0.67) |
1.07 mm
(95%CI 0.74 – 1.42) |
Conclusions
The authors concluded
it should be pointed out that there is a need for a further well-designed controlled clinical trials with homogenous criteria, reporting on long-term results of implant therapy on subjects with a history of aggressive periodontitis also taking into account the confounding factors (smoking, compliance, maintenance programs), to further elucidate the possible higher risk for biological complications at implants in this cluster.
Comments
This review addresses the same question as a the 2014 review by Monje et al (Dental Elf – 10th Nov 2014). While it includes one additional study this does not add significant new information to the earlier findings. The studies are relatively small and of short duration, a majority also stem from the same research group. Consequently, the findings should be viewed cautiously. Well-conducted high quality studies of appropriate size and duration are required.
Links
Primary paper
Theodoridis C, Grigoriadis A, Menexes G, Vouros I. Outcomes of implant therapy in patients with a history of aggressive periodontitis. A systematic review and meta-analysis. Clin Oral Investig. 2016 Dec 24. doi: 10.1007/s00784-016-2026-6. [Epub ahead of print] Review. PubMed PMID: 28013438.
Other references
Dental Elf – 10th Nov 2014
Dental Implants : higher failure rates in patients with aggressive periodontitis?
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