# Peri-implantitis, Risk of Recurrence and Implant Loss in Soldiers with Stage III/IV Periodontitis during 20–30 Years of Supportive Periodontal Therapy (SPT)

## TL;DR

This study found that soldiers with severe periodontitis who received long-term dental care had a high risk of peri-implantitis and implant loss, especially if they were heavy smokers or had stage IV periodontitis.

## Contribution

The study provides long-term data (20–30 years) on peri-implantitis recurrence and implant survival in patients with severe periodontitis.

## Key findings

- 33% of implant patients developed peri-implantitis, affecting 25% of implants.
- 11% of all implants were lost within 10 years due to peri-implantitis.
- Implant loss and peri-implantitis were more common in stage IV periodontitis and heavy smokers.

## Abstract

To help fill the knowledge gaps regarding the long-term effectiveness of peri-implantitis therapy, this retrospective study of soldiers with treated severe periodontitis (stage III gen. / IV) who had been undergoing adherent SPT for at least 20 years aimed to determine the frequency of peri-implantitis and patient-related risk factors for this, as well as the 10-year survival rates of dental implants under peri-implantitis therapy.

The observation period was between 1993 and 2023. All patients were referred by their military dentists for specialist dental training and underwent systematic periodontal therapy. A multi-stage peri-implantitis treatment concept was used.

In 86 (31%) of 276 patients (total treatment time 23.6 ± 2.8 years, 53.1 ± 20.4 SPT sessions), 296 implant restorations were performed to close gaps or lengthen rows of teeth. In 29 (33%) of the implant patients, peri-implantitis developed on 25% of the implants. As a result, 11% of all implants were lost within 10 years due to peri-implantitis. Peri-implantitis led to implant loss in 59% of affected patients and 45% of implants. The survival time of implants lost later was 8.4 ± 6.2 years. Peri-implantitis and implant loss rates increased statistically significantly in stage IV periodontitis as well as in heavy smokers. Patients with implant loss and peri-implantitis had received systemic antibiotics due to periodontitis recurrence statistically significantly more frequently than patients without peri-implantitis and without implants during the ≥ 20-year SPT (p < 0.05).

Based on the present results, the early extraction of teeth during SPT in patients with treated generalised periodontitis stage III and stage IV plus replacement with implants is not advantageous.