Clinical outcomes of dental implants in patients with and without history of periodontitis: A 20‐year prospective study

AIM: To present the 20‐year clinical outcomes of tissue‐level implants in partially edentulous patients previously treated for periodontitis and in periodontally healthy patients (PHP). MATERIAL AND METHODS: The original population consisted of 149 partially edentulous patients consecutively enrolled in a private specialist practice and divided into three groups: PHP, moderately periodontally compromised patients (mPCP) and severely PCP (sPCP). After successful completion of periodontal/implant therapy, patients were enrolled in an individualized supportive periodontal care (SPC) programme. RESULTS: Eighty‐four patients rehabilitated with 172 implants reached the 20‐year examination. During the observation time, 12 implants were removed (i.e., 11 due to biological complications and 1 due to implant fracture), leading to an overall implant survival rate of 93% (i.e., 94.9% for PHP, 91.8% for mPCP and 93.1% for sPCP [p = .29]). At 20 years, PCP compliant with SPC did not present with significantly higher odds of implant loss compared with PHP compliant with SPC (p > .05). Conversely, PCP not compliant with SPC experienced implant loss with odds ratio of 14.59 (1.30–164.29, p = .03). CONCLUSIONS: Tissue‐level implants, placed after comprehensive periodontal therapy and SPC, yield favourable long‐term results. However, patients with a history of periodontitis and non‐compliant with SPC are at higher risk of biological complications and implant loss.