Research Corner - Prevalence, incidence, systemic, behavioural, and patient-related risk factors and indicators for peri-implant diseases: An AO/AAP systematic review and meta-analysis
Mr Alex Pollard, Honorary Editor, has kindly written a precis of a recently published article.
Prevalence, incidence, systemic, behavioral, and patient-related risk factors and indicators for peri-implant diseases: An AO/AAP systematic review and meta-analysis
A recent systematic review with meta analysis in the Journal of Periodontology has pulled together over 13,000 patients and provided an update on just how common peri implant disease is.
Almost half of patients with implants will experience peri implant mucositis at some point in their lives, while about one in five will develop peri-implantitis. These figures are reported at the patient level, which is preferable as it reflects clinical reality because most people have multiple dental implants and even a single diseased implant is important for that person. Results showed that at five years mucositis affects around 46 percent of patients and peri-implantitis 12 percent. By ten years mucositis rises to 61 percent and peri-implantitis 14 percent. At twenty years peri-implantitis is reported in 22 percent of patients.
The review also explored what drives this risk. For mucositis the strongest indicators were a history of periodontitis, smoking and obesity. For peri-implantitis the main risk factors included a history of periodontitis, diabetes, and smoking. Age and sex showed no consistent influence. Cardiovascular conditions and obesity were linked in some studies but the evidence was not uniform. It should be noted that the authors did not explore site specific risk factors such as keratinized mucosa or prosthesis design.
For practice this reinforces what many of us see every day. The periodontitis patient who has moved into implant care does not leave their risk profile behind. Maintenance must be structured and tailored. Patients with smoking habits, diabetes or a strong periodontitis history need greater support, closer recalls and clear conversations about risk.
It is worth noting that the review highlighted some important limitations. Definitions of peri implant disease varied across studies and diagnostic thresholds were not uniform, which may influence prevalence estimates. The review highlights that long-term mucositis data are sparse, especially beyond 10 years, and risk indicators were mostly reported qualitatively rather than as pooled odds ratios (or similar measures) due to differences in study design and definitions. These caveats remind us to interpret the results with caution, even though the overall message remains clear.
Despite the limitations, the take home message is simple. Peri implant disease is common, it follows similar patient-level risk patterns we know from periodontitis, and the need for lifelong maintenance is essential.