Risk Factors for Peri-Implantitis: Effect of History of Periodontal Disease and Smoking Habits. A Systematic Review and Meta-Analysis.
OBJECTIVE
The purpose of this review was to evaluate whether history of periodontitis and smoking habits could represent a risk factor for peri-implantitis and implant loss.


METHODS
This systematic review followed PRISMA guidelines and was registered at the PROSPERO database [registration numbers CRD42016034160 (effect of history of periodontitis) and CRD42016033676 (effect of smoking)]. Broad electronic (MEDLINE) and manual searches were conducted among articles published from January 1st1990 up to December 31st2015, resulting in 49332 records for history of periodontitis and 3199 for smoking habits. Selection criteria included prospective studies comparing two cohorts of patients, with and without the investigated risk factor, with a minimum follow-up period of three years, and reporting data on peri-implantitis and implant loss occurrence. Considering that only prospective studies were included, dichotomous data were expressed as risk ratios and 95% confidence intervals.


RESULTS
Three studies evaluating history of periodontitis (on which quantitative analysis was performed) and one study on smoking effect were included. Both implant and patient-based meta-analyses revealed a significantly higher risk of developing peri-implantitis in patients with a history of periodontitis compared with periodontally healthy subjects, but not a statistically significant increased risk for implant loss.


CONCLUSIONS
The outcomes of this systematic review indicate history of periodontitis as a possible risk factor for peri-implantitis, while insufficient data are present in literature to evaluate the role of smoking. However, available evidence is still weak and immature, and sound epidemiological studies are needed to analyse the specific contribution of these potential risk factors.
Department of Medical, Surgical and Health Sciences, University of Trieste Italy.
Claudio
C
Stacchi
Department of Medical, Surgical and Health Sciences, University of Trieste Italy.
Federico
F
Berton
Department of Medical, Surgical and Health Sciences, University of Trieste Italy.
Giuseppe
G
Perinetti
Department of Medical, Surgical and Health Sciences, University of Trieste Italy.
Andrea
A
Frassetto
Private Practice, Cassano allo Ionio Italy.
Teresa
T
Lombardi
Department of Medical, Surgical and Health Sciences, University of Trieste Italy.
Aiman
A
Khoury
Private Practice, Trieste Italy.
Francesca
F
Andolsek
Department of Medical, Surgical and Health Sciences, University of Trieste Italy.
Roberto
R
Di Lenarda
dental implants; peri-implantitis; periodontitis; risk factors; smoking; systematic review