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Clin Oral Implants Res. 2019 Apr;30(4):306-314. doi: 10.1111/clr.13416. Epub 2019 Mar 10.

Peri-implantitis prevalence, incidence rate, and risk factors: A study of electronic health records at a U.S. dental school.

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Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York City, New York.
Center for Bioinformatics and Data Analytics in Oral Health, Columbia University College of Dental Medicine, New York City, New York.



We assessed peri-implantitis prevalence, incidence rate, and associated risk factors by analyzing electronic oral health records (EHRs) in an educational institution.


We used a validated reference cohort comprising all patients receiving dental implants over a 3.5-year period (2,127 patients and 6,129 implants). Electronic oral health records of a random 10% subset were examined for an additional follow-up of ≥2.5 years to assess the presence of radiographic bone loss, defined as >2 mm longitudinal increase in the distance between the implant shoulder and the supporting peri-implant bone level (PBL) between time of placement and follow-up. "Intact" implants had no or ≤2 mm PBL increase from baseline. Electronic oral health record notes were reviewed to corroborate a definitive peri-implantitis diagnosis at implants with progressive bone loss. A nested case-control analysis of peri-implantitis-affected implants randomly matched by age with "intact" implants from peri-implantitis-free individuals identified putative risk factors.


The prevalence of peri-implantitis over an average follow-up of 2 years was 34% on the patient level and 21% on the implant level. Corresponding incidence rates were 0.16 and 0.10 per patient-year and implant-year, respectively. Multiple conditional logistic regression identified ill-fitting fixed prosthesis (OR = 5.9; 95% CI: 1.6-21.1), cement-retained prosthesis (OR = 4.5; 2.1-9.5), and radiographic evidence of periodontitis (OR = 3.6; 1.7-7.6) as statistically associated with peri-implantitis. Implant location in the mandible (OR = 0.02; 0.003-0.2) and use of antibiotics in conjunction with implant surgery (OR = 0.19; 0.05-0.7) emerged as protective exposures.


Approximately 1/3 of the patients and 1/5 of all implants experienced peri-implantitis. Ill-fitting/ill-designed fixed and cement-retained restorations, and history of periodontitis emerged as the principal risk factors for peri-implantitis.


epidemiology; periodontology; soft tissue-implant interactions

[Indexed for MEDLINE]

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