Abstract：
BACKGROUND: Dental implants are widely employed as dependable replacements for lost teeth. However, it is crucial to establish, solely through prospective cohort studies, whether a history of periodontitis indeed constitutes a significant risk factor for implant failure.
METHODS: A systematic literature search was conducted in October 2022 in several electronic databases with subsequent manual updates. Only original prospective cohort studies evaluating the implant (loss) rate ≥1 year after implant loading were included. Logarithmic risk ratio and weighted mean differences were calculated. Study results were summarized using random effects meta-analyses evaluated by trial sequential analyses. The Newcastle-Ottawa scale evaluated study bias and the GRADE approach assessed the certainty/quality of the evidence.
RESULTS: A total of 14 publications reporting on 12 prospective cohort studies were included. Low evidence certainty/quality evidence due to the absence of randomized clinical trials revealed significantly greater odds of failure in patients with a history of periodontitis at follow-ups both after ≤5 years (RR = 1.62; 95% CI: 1.71-2.37; p = 0.013) and >5 years (RR = 2.26; 95% CI: 1.12-4.53; p = 0.023). The incidence of peri-implantitis (RR = 4.09; 95% CI: 1.93-8.58; p < 0.001) and the weighted mean (WM) of marginal bone loss (WM difference = 0.75 mm; 95% CI: 0.18-1.31; p < 0.05) were statistically significantly greater in the periodontally compromised group, whereas there was no significant difference between the two groups for peri-implant probing depth.
CONCLUSIONS: A history of periodontitis can be considered a significant risk factor for incident implant failure, peri-implantitis, and greater marginal bone loss.
METHODS: A systematic literature search was conducted in October 2022 in several electronic databases with subsequent manual updates. Only original prospective cohort studies evaluating the implant (loss) rate ≥1 year after implant loading were included. Logarithmic risk ratio and weighted mean differences were calculated. Study results were summarized using random effects meta-analyses evaluated by trial sequential analyses. The Newcastle-Ottawa scale evaluated study bias and the GRADE approach assessed the certainty/quality of the evidence.
RESULTS: A total of 14 publications reporting on 12 prospective cohort studies were included. Low evidence certainty/quality evidence due to the absence of randomized clinical trials revealed significantly greater odds of failure in patients with a history of periodontitis at follow-ups both after ≤5 years (RR = 1.62; 95% CI: 1.71-2.37; p = 0.013) and >5 years (RR = 2.26; 95% CI: 1.12-4.53; p = 0.023). The incidence of peri-implantitis (RR = 4.09; 95% CI: 1.93-8.58; p < 0.001) and the weighted mean (WM) of marginal bone loss (WM difference = 0.75 mm; 95% CI: 0.18-1.31; p < 0.05) were statistically significantly greater in the periodontally compromised group, whereas there was no significant difference between the two groups for peri-implant probing depth.
CONCLUSIONS: A history of periodontitis can be considered a significant risk factor for incident implant failure, peri-implantitis, and greater marginal bone loss.
摘要：
背景:牙科植入物被广泛用作缺失牙齿的可靠替代品。然而,至关重要的是建立，仅通过前瞻性队列研究，牙周炎病史是否确实构成种植失败的重要危险因素。
方法：2022年10月在几个电子数据库中进行了系统的文献检索，随后进行了手动更新。仅包括评估植入物装载后≥1年的植入物（丢失）率的原始前瞻性队列研究。计算对数风险比和加权平均差。使用随机效应荟萃分析对研究结果进行总结，通过试验序贯分析进行评估。纽卡斯尔-渥太华量表评估了研究偏倚，GRADE方法评估了证据的确定性/质量。
结果：共14篇报告了12项前瞻性队列研究的出版物。由于缺乏随机临床试验，证据确定性/质量较低，在≤5年（OR=1.65；95％CI：1.12-2.44；p=0.012）和>5年（OR=2.36；95％CI：1.13-4.95；p=0.023）的随访中，有牙周炎病史的患者的失败几率明显更高。种植体周围炎的发生率（OR=5.93；95％CI：2.75-12.8；p<0.001）和边缘骨丢失的加权平均值（WM）（WM差异=0.75mm；95％CI：0.18-10.3；p<0.05）在牙周受损组中具有统计学意义，而两组种植体周围探查深度无显著差异。
结论：牙周炎病史可以被认为是种植体失败的重要危险因素。种植体周围炎,和更大的边缘骨质流失。
方法：2022年10月在几个电子数据库中进行了系统的文献检索，随后进行了手动更新。仅包括评估植入物装载后≥1年的植入物（丢失）率的原始前瞻性队列研究。计算对数风险比和加权平均差。使用随机效应荟萃分析对研究结果进行总结，通过试验序贯分析进行评估。纽卡斯尔-渥太华量表评估了研究偏倚，GRADE方法评估了证据的确定性/质量。
结果：共14篇报告了12项前瞻性队列研究的出版物。由于缺乏随机临床试验，证据确定性/质量较低，在≤5年（OR=1.65；95％CI：1.12-2.44；p=0.012）和>5年（OR=2.36；95％CI：1.13-4.95；p=0.023）的随访中，有牙周炎病史的患者的失败几率明显更高。种植体周围炎的发生率（OR=5.93；95％CI：2.75-12.8；p<0.001）和边缘骨丢失的加权平均值（WM）（WM差异=0.75mm；95％CI：0.18-10.3；p<0.05）在牙周受损组中具有统计学意义，而两组种植体周围探查深度无显著差异。
结论：牙周炎病史可以被认为是种植体失败的重要危险因素。种植体周围炎,和更大的边缘骨质流失。
