Dental Implants : higher failure rates in patients with aggressive periodontitis?


It has been reported that patients with periodontal disease have a higher level of peri-implantitis and lower implant survival rates that periodontally health patients.

The aim of this review was to assess whether generalised aggressive periodontitis (GAgP) has similar survival rates (SRs) and marginal bone loss (MBL) when compared with patients with chronic periodontitis (CP) and/or healthy patients (HPs).


Searches were conducted in the Medline, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Oral Health Group Trials Register databases. This was supplemented by handsearches in a number of implant related journals and the reference lists of identified articles. Prospective or retrospective trials with more than 12 months follow up after implant loading where outcomes of the implant-supported prosthesis in patients with a history of GAgP were compared with another group were considered. The primary outcomes were survival rates (SRs) and marginal bone loss (MBL). Two reviewers independently assessed study quality was by using the Newcastle-Ottawa scale (NOS).


  • 6 studies (290 patients, 834 implants) were included.
  • All 6 were prospective studies.
  • Follow up periods ranged from 12- 120 months.
  • 5 out of 6 studies were from the same research group.


Generalised aggressive periodontitis   vs Healthy Patients

Risk Ratio (95% CI)

Generalised aggressive periodontitis   vs chronic periodontitis

Risk Ratio (95% CI)

Implant survival

0.96 (0.91 to 1.01)

0.94   (0.87 to 1.01

‘failure rate’

4.00 (1.79 to 8.93)*

3.97 (1.68 to 9.37)*

* Significant P <0.001

Marginal bone loss

WMD (95% CI)

Healthy Patients vs Chronic periodontitis

0.15 mm (0.04 to 0.26)

Healthy Patients vs generalised aggressive periodontitis

-0.28 mm (-0.36 to -0.19)

Chronic periodontitis vs generalised aggressive periodontitis

-0.43 mm (-0.53 to -0.33)

WMD = Weighted mean difference


The authors concluded

Implant placement in patients with a history of GAgP might be considered a viable option to restore oral function with survival outcomes similar to those found in both patients with CP and HPs. However, the risk ratio for failure in patients with GAgP is significantly higher when compared with HPs (4.0) and those with CP (3.97)


This review considers a similar question to the review we reported last week (Dental Elf 7th Nov 2014). In that review they had a much clearer definition on implant failure (complete loss) whereas here it is unclear. This review focuses one studies involving GAgP, which is much less prevalent, so far fewer studies are included. While all the included studies were rated as medium high quality on the NOS they were relatively small and all bar one are from the same research group. The review we considered last week looked more widely at failure rates in periodontal compromised compared with periodontally health patients and suggested that periodontitis increased the risk of implant failure.


Monje A, Alcoforado G, Padial-Molina M, Suarez F, Lin GH, Wang HL. Generalized aggressive periodontitis as a risk factor for dental implant failure: a systematic review and meta-analysis. J Periodontol. 2014 Oct;85(10):1398-407. doi: 10.1902/jop.2014.140135. Epub 2014 May 16. PubMed PMID: 24835415.

Dental Elf 7th Nov 2014 – Dental Implants: review suggests failure rates higher in periodontally compromised patients but evidence is low quality

Dental Elf 16th Jan 2014 – Periodontitis is a risk factor for dental implant loss and peri-implantitis

Newcastle-Ottawa Scale 

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