Clinical and radiographic study of implant treatment outcome in periodontally susceptible and non‐susceptible patients: a prospective long‐term study

OBJECTIVES: To evaluate the implant survival rate, periodontal and radiographic parameters of non-submerged screw implants with two different surfaces (TPS and SLA) in periodontally non-susceptible patients (NSP) and in patients with chronic adult periodontitis (CAP) or with generalized aggressive periodontitis (GAP). MATERIAL AND METHODS: In 110 healthy partially edentulous subjects, 68 patients with CAP and 16 patients with GAP, a total of 513 implants were installed and followed for on average 48.1+/-25.9 months. Only fixed partial dentures were used as suprastructures. All patients were offered a supportive periodontal maintenance program. Smoking habits, health impairment, plaque score, bleeding on probing (BOP), type of surface, bone score, bone loss on radiographs and the number of failed implants were noted. RESULTS: Implant survival in the NSP and CAP group was 98% and 96% after 140 months (NS), but only 80% after 100 months in the GAP group (P=0.0026). The overall rate of implant loss was 4.7%, but 15.25% in the GAP group (6/16 patients). The average marginal bone loss for all implants was 0.12+/-0.71 mm on the mesial side and 0.11+/-0.68 mm on the distal side. Bone loss/year was 0.08+/-0.31 and 0.07+/-0.3 mm in the NSP group, but 0.17+/-0.2 and 0.17+/-0.19 mm in the GAP group. Only in the GAP group, was bone loss significantly related to BOP, age, inflammation, presence of plaque, probing depth. Implants with a TPS surface had a lower survival than implants with an SLA surface (93% vs. 97%; P=0.06), especially in the GAP group (80% vs. 83%; P=0.005). Smoking habits had a significant influence on implant survival only in the GAP group (P=0.07), declining in current smokers to 63%, and to 78% in former smokers. Overall, impaired general health had no significant influence (P=0.85). However, impaired health further reduced implant survival in the GAP group (survival: 71%). In a statistical model to predict the chance for implant failing, only periodontal classification (P=0.012) and implant surface type (P=0.027) were significant. CONCLUSION: Periodontally healthy patients and patients with CAP show no difference in peri-implant variables and implant survival rate, but patients with GAP have more peri-implant pathology, more marginal bone loss and a lower implant survival implant rate. SLA surface had a better prognosis than the TPS surface.