Factors Pertinent To Peri-implantitis:a Systematic Review And Meta-analysis

OBJECTIVE:Peri-implantitis is a complex inflammatory response which is influenced by multiple factors.The success rate and survival rate of implants will be increased if the risk factors can be avoided and favourable factors can be promoted.The objective of this systematic review was to evaluate the relationship between influence factors and peri-implantitis.METHODS:Pubmed?EMbase and the Cochrane Library were electronically searched to collect randomized controlled trials(RCT),cohort studies and case-control study about the risk factors pertinent to peri-implantitis until March 1,2018.Two reviewers independently screened literature,extracted data and assessed the risk bias of included studies.Then,Meta-analysis was performed using RevMan 5.3 software.When heterogeneity was absent in the included trials(P>0.1 and I~2<50%),a fixed-effect model was used;otherwise,the random-effects model was applied.RESULTS:Seven studies with 2067 study participants fulfilled the inclusion criteria required to analyze factors pertinent to peri-implantitis.A total of four observation indicators were obtained,including periodontitis,smoking,diabetes mellitus,preventive maintenance.The results of Meta-analysis showed that:periodontitis can increase the incidence of peri-implantitis[RR:2.46;95%CI:1.77-3.43;P<0.00001],meanwhile the incidence of peri-implantitis in patients with severe periodontitis was significantly higher than that of moderate periodontitis[RR:0.35;95%CI:0.13-0.96;P=0.04].Smoking[RR:1.55;95%CI:1.31-1.84;P<0.00001]and diabetes mellitus[RR:1.74;95%CI:1.36-2.23;P<0.0001]both can increase the incidence of peri-implantitis.But there is no statistically difference between former smoking group and non-smoking group[RR:1.68;95%CI:0.97-2.89;P=0.06].Preventive maintenance can reduce the incidence[RR:0.41;95%CI:0.19-0.87;P=0.02].CONCLUSIONS:The data suggest that periodontal disease,smoking and diabetes mellitus can increase the prevalence of peri-implantitis.Meanwhile,the incidence of peri-implantitis in patients with severe periodontitis was significantly higher than those with moderate periodontitis while former smoking history has no obviously influence.Patients with regular preventive maintenance can reduce the incidence.