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Residual Periodontal Pockets at Implant Placement as Risk Indicator for Peri-Implantitis: A Systematic Review
Francesco Ferrarotti1, Giacomo Baima1, Alessandro Campagna1
1Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy.
Clinical Implant Dentistry and Related Research
|July 28, 2026
Summary
Residual periodontal pockets (PPD) after treatment increase the risk of peri-implantitis in patients with dental implants. Deeper pockets and more affected sites heighten this risk, underscoring the need for careful monitoring.
Area of Science:
- Periodontology
- Implant Dentistry
- Oral Health Research
Background:
- Periodontitis is a chronic inflammatory disease affecting gums and supporting bone.
- Dental implants are a common solution for missing teeth in patients with a history of periodontitis.
- Residual periodontal pockets (PPD) may persist after active periodontal therapy.
Purpose of the Study:
- To systematically review the risk of peri-implantitis associated with residual periodontal pockets (PPD) in patients with treated periodontitis who received dental implants.
- To assess the influence of residual PPD and furcation involvement on peri-implantitis development.
Main Methods:
- Systematic review of electronic databases (MEDLINE, Scopus, Embase, Cochrane Library).
- Inclusion of cohort studies with dental implants and recorded residual PPD or furcation involvement.
- Primary outcome: incidence of peri-implantitis. Risk of bias assessed using the Newcastle-Ottawa Scale.
Main Results:
- Four cohort studies met inclusion criteria, with follow-up up to 23 years.
- Consistent association found between residual PPD and increased peri-implantitis risk.
- Deeper PPD (≥5 or ≥6 mm) and higher proportions of diseased sites correlated with greater risk; one study noted increased risk with adjacent inflammatory periodontal conditions.
Conclusions:
- Residual periodontal pockets (PPD) persisting after active periodontal therapy increase peri-implantitis risk in patients with treated periodontitis receiving dental implants.
- Further prospective studies with standardized peri-implantitis definitions are needed to clarify the impact of residual PPD and furcation involvement.
