Rheumatoid Arthritis Linked to Higher Peri-Implantitis Risk Despite Comparable Implant Survival Rates: Study

The findings, published in the Journal of Periodontology, revealed that patients with rheumatoid arthritis were at a greater risk of developing peri-implantitis (PI) compared to healthy individuals. Despite this, both groups demonstrated a 96% implant survival rate and comparable levels of marginal bone loss. Over five years, the study, which analyzed clinical and radiographic data, observed significantly elevated rates of PI in the RA group. In contrast, the non-RA group exhibited a higher prevalence of peri-implant mucositis.

Rheumatoid arthritis, a chronic autoimmune disorder primarily affecting joints, has been linked to systemic inflammation, potentially impacting oral health. With the increasing prevalence of dental implants as a solution for tooth loss, understanding how RA may influence implant outcomes is critical for improving patient care. Considering this, Muhammad H. A. Saleh, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA, and colleagues sought to examine the impact of rheumatoid arthritis on the occurrence of peri-implantitis and peri-implant mucositis (PIM).

For this purpose, the researchers conducted radiographic and clinical chart reviews to assess probing depth (PD), bleeding on probing, and marginal bone loss (MBL) around implants, diagnosing peri-implant diseases using the 2017 workshop classification. Measurements were taken at baseline (T0) and the last available records (T1). Maintenance compliance was evaluated, and cases were followed longitudinally to track the incidence of peri-implantitis (PI) and peri-implant mucositis.

To ensure accuracy, potential confounders such as follow-up times, maintenance visits, implant dimensions, history of periodontitis, bone grafts, restoration angles, smoking, and diabetes were controlled. Statistical analysis included chi-square and Mann–Whitney tests for categorical and continuous variables. Generalized estimating equations with a Tweedie distribution were applied, while binary logistic regression determined odds ratios for binary outcomes.

Key Findings:

• The study included 101 patients (50 with RA and 51 without RA) with 124 implants. The average follow-up period for the implants was 5.38 ± 2.22 years.
• The overall implant survival rate was 96%.
• Patients in the RA group had a significantly higher incidence of peri-implantitis.
• The non-RA group had a significantly higher incidence of peri-implant mucositis.
• There were no significant differences between the groups in implant survival or marginal bone loss (MBL).

The study concluded that patients with rheumatoid arthritis exhibited comparable marginal bone loss and implant survival rates to those without RA. However, RA patients had a significantly lower incidence of peri-implant mucositis but a markedly higher incidence of peri-implantitis.

Reference:

Almashni, H., Kakar, E., Nava, P., Wang, L., & A. Saleh, M. H. Influence of rheumatoid arthritis on peri-implant diseases: A longitudinal retrospective clinical and radiographic evaluation. Journal of Periodontology. https://doi.org/10.1002/JPER.24-0376