Dental implant outcomes may vary in patients with a history of periodontal disease.
METHODS
This systematic review used a set of defined inclusion criteria and identified 4448 publications. These were sorted and 10 were identified with sufficient strength to be considered in the systematic review. The authors used a series of inclusion criteria to sort though the identified systematic reviews on this topic. Criterion included the following: use of longitudinal studies (up to March 2006) or case series in which all subjects were included, studies addressing only partially edentulous subjects in which a variety of implant systems were used, and reviews that classified and ranked quality of the studies (eg, > 6-month recall, > 10 subjects). All studies were located through a search of MEDLINE and EMBASE.


METHODS
The primary prognostic factor in this study was to identify dental implant outcomes (survival or success as defined by the respective studies) and reports of peri-implantitis in subjects with a previous history of periodontitis.


METHODS
The authors focused on 3 outcome measures: implant survival, implant success, and peri-implantitis. The authors' inclusion criteria were generally all inclusive and did not limit studies based on definitions of these 3 outcomes.


RESULTS
The authors state that "overall, the non-periodontitis patients demonstrated better outcomes than treated periodontitis patients," yet they admit that there is a "medium to high level of bias" with a lack of consistent outcome variables. They correctly state that owing to the heterogeneity of study designs (p. 459), they were not able to provide a meta-analysis. Unfortunately, the strength of the associations claimed are difficult to assess because there were no reports of odds ratios or confidence intervals. They also report significant inconsistencies between studies for the key outcome variables. For instance, only 3 of the 9 studies reviewed reported any form of peri-implant bone loss associated with inflammation (peri-implantitis). Bone loss was statistically observed in only 1 study, with a nonsignificant trend of greater bone loss in the subjects who had a history of periodontitis in the other studies reviewed.


CONCLUSIONS
The authors suggest there is "some evidence" that patients treated for periodontitis may experience more implant loss and complications around implants than patients without periodontitis.
Stanford
Clark
C
University of Iowa, Iowa City, Iowa 52242, USA. Clark-Stanford@uiowa.edu