Factors influencing severity of peri‐implantitis

Objectives To retrospectively assess the influence of potential risk factors, primarily smoking and a prior history of periodontitis, on the severity of peri‐implantitis in patients referred for treatment of peri‐implantitis. Materials and methods Among 98 patients referred for treatment of peri‐implantitis, 34 patients fulfilled the inclusion criteria: one or several implants with peri‐implant marginal bone loss ≥2 mm concomitant with bleeding and/or pus on probing. Information about health status, smoking habits, reason for tooth loss, and performed implant treatment were obtained from the patient charts and interviews. Moreover, a detailed extra‐ and intraoral examination was performed, including intraoral radiographs of all implants. Risk factors were evaluated by a two‐way anova at patient level. Results Smoking and a prior history of periodontitis were significant risk factors for increased severity of peri‐implantitis. Furthermore, the presence of both smoking and a prior history of periodontitis did not further increase the severity of peri‐implantitis, as compared to either of these two factors alone. Poor marginal fit of the suprastructure and extensive gingival imitations on implant‐supported fixed full prostheses may also be potential risk factors. Conclusions The study indicated that smoking and a prior history of periodontitis were important risk factors for increased severity of peri‐implantitis, while concomitant presence of these two risk factors did not further increase the severity of peri‐implantitis, as compared to either of these two risk factors alone. Therefore, early diagnosis and adequate treatment of peri‐implantitis are important in patients with a prior history of periodontitis and in smokers to minimize the risk of advanced peri‐implantitis in conjunction with focus on known risk factors, including meticulous infection control before implant treatment and a systematic maintenance care program.