Background
Periodontitis is a gum disease. Periodontics is the recognized dental specialty for disease of the tissues around the teeth or their substitutes, which includes implants.1
What the research shows
A 2025 meta-analysis by Annunziata and colleagues pooled 14 prospective studies with at least 3 years of follow-up.2 It compared patients with and without a history of periodontitis.2
| Outcome | History of periodontitis vs none |
|---|---|
| Implant loss | Hazard ratio 1.75 (higher risk) |
| Peri-implantitis | Odds ratio 3.24 (higher risk) |
| Bone loss | 0.41 mm more |
| Peri-implant mucositis | No significant difference |
Higher risk of implant loss was also found for stage III to IV (severe) periodontitis and for rough-surface implants.2 Risk of implant loss was higher still in two groups: at 10 or more years of follow-up (hazard ratio 2.02) and in patients with a history of grade C, rapidly progressing periodontitis (hazard ratio 6.16).2
Maintenance
A 2016 meta-analysis found that a history of periodontal disease affected peri-implantitis at both the implant and the patient level.3 The same review supported maintenance recall at least every 5 to 6 months, tailored to each patient's risk.3 The authors added that biologic complications can still occur with maintenance in place.3 The AAP lists previous periodontal disease as a risk factor for peri-implant disease.4
Who treats it
Periodontists specialize in both periodontal disease and the placement of implants.5 The AAP states that some general dentists refer more challenging implant cases to periodontists.5
Questions to ask
- Is the gum disease currently stable.
- How often maintenance visits are planned after the implants are placed.
- Who will provide the maintenance care.
General information about dental implants. Treatment decisions are made with a licensed dentist.
Sources
- National Commission on Recognition of Dental Specialties and Certifying Boards: Recognized Dental Specialties. ncrdscb.ada.org
- Annunziata M et al. Implant therapy in patients with and without a history of periodontitis: systematic review. J Periodontal Res 2025. pubmed.ncbi.nlm.nih.gov
- Monje A et al. Impact of maintenance therapy for the prevention of peri-implant diseases. J Dent Res 2016. pubmed.ncbi.nlm.nih.gov
- American Academy of Periodontology: Peri-Implant Diseases. perio.org
- American Academy of Periodontology: What is a Periodontist?. perio.org
