Long-Term Implant Survival in Periodontitis

This study assessed whether periodontitis stage and grade are associated with long-term implant survival in periodontally compromised patients.

A retrospective analysis was conducted among 362 periodontitis patients who received 1106 implants at the University Clinic Münster, Germany, with a median follow-up of 85.5 months (range: 3.6-236.4). Periodontitis stage and grade were assessed based on clinical and radiographic data at the first clinical visit. Kaplan-Meier curves and Cox regression models were used to analyze implant survival.

A total of 85 implants (7.69%) failed, with nearly half of these losses occurring within the first six months (failed osseointegration). Cumulative survival rates were 95.8% at 60 months, 91.1% at 120 months, and 82.6% at 180 months. Grading, but not staging, was significantly associated with implant loss. Patients classified as grade C had a higher risk of implant loss at any given time during follow-up than patients with grade A or B (hazard ratio = 2.78; 95% confidence interval: 1.18-6.54).

Our findings demonstrate that periodontitis, particularly in terms of grading as defined by the current classification, is a significant risk factor for implant loss, even in patients undergoing periodontal therapy. Both clinicians and patients should consider these risk factors during treatment planning, as they can substantially impact implant survival. Nevertheless, dental implants remain a reliable and predictable therapeutic option, even for patients with severe periodontitis.