title: Periodontitis, implant loss and peri-implantitis. A meta-analysis.
abstract: OBJECTIVE
  The aim of the present systematic review and meta-analysis was to assess the role of periodontal disease as a risk factor for implant loss, peri-implantitis and implant-bone loss.
  
  
  METHODS
  Six electronic database and a manual search resulted in 7391 unique publications; after selection only 16 studies were included in systematic review. Dichotomous data were expressed as risk ratio (RR) and 95% confidence interval (CI), while continuous data were expressed as standardized mean difference (SMD). Due to the expected inter-study heterogeneity, a random effect model was used for both type of data. The pooled effect was considered significant for a P < 0.05.
  
  
  RESULTS
  Meta-analysis revealed that an higher and significant risk for implant loss was present in patients affected by PD (RR: 1.69, 95% CI: 1.31-2.17, P < 0.0001). A higher and significant IBL was present in patients with periodontal disease, when compared with patients periodontally healthy (SMD: 0.38, 95% CI: 0.18-0.58, P = 0.0002). Patients periodontally compromised showed an increased risk of PI, when compared with patients without periodontitis (RR: 2.17, 95% CI: 1.51-3.12, P < 0.0001) No evidence of significant heterogeneity was detected for the three outcomes.
  
  
  CONCLUSIONS
  Strong evidence suggests that periodontitis is a risk factor for implant loss; moderate evidence revealed that periodontitis is a risk factor for peri-implantitis and that patients with periodontitis have higher implant-bone loss.
authors.affiliation: Department of Life Health and Environmental Sciences, School of Dentistry, University of L'Aquila, L'Aquila, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Sgolastra
authors.affiliation: Department of Life Health and Environmental Sciences, School of Dentistry, University of L'Aquila, L'Aquila, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Petrucci
authors.affiliation: Department of Life Health and Environmental Sciences, School of Dentistry, University of L'Aquila, L'Aquila, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Severino
authors.affiliation: Department of Life Health and Environmental Sciences, School of Dentistry, University of L'Aquila, L'Aquila, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Gatto
authors.affiliation: Department of Life Health and Environmental Sciences, School of Dentistry, University of L'Aquila, L'Aquila, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Monaco
mesh_terms: D016301:Alveolar Bone Loss / Q000209:etiology*; D015921:Dental Implants; D019232:Dental Restoration Failure; D006801:Humans; D057873:Peri-Implantitis / Q000209:etiology*; D010518:Periodontitis / Q000150:complications*; D012307:Risk Factors
chemical_list: D015921:Dental Implants
keywords: aggressive periodontitis; chronic periodontitis; dental implants; meta-analysis; peri-implantitis; periodontitis