The evaluation of the relationship between peri-implant and periodontal tissue health

The aim of this cross-sectional study is to evaluate the relationship between periodontal and peri-implant tissue health. The study included 159 patients aged between 24 and 88 years and 451 dental implants. The measurements of all implants and teeth included PD, GI, PI, BOP, MR, suppuration, and CBL. Based on the measurements, implants were categorized into peri-implant mucositis and peri-implantitis; patients were categorized into gingivitis and periodontitis. Periodontitis patients were further divided according to the severity (stage 1, 2, 3, 4) and grade (A, B, C). Clinical and radiological data were statistically analyzed using Mann-Whitney U, Kruskal-Wallis, Pearson chi-square, Dunn test, Monte Carlo corrected Fisher exact test, Bonferroni corrected z test, and Spearman's rho correlation test. Robust regression analysis and binary logistic regression analysis were performed to test the potential relationships between peri-implant parameters and periodontal disease and to evaluate possible risk factors. It was found that 203 implants (45%) had gingivitis and 248 implants (55%) had periodontitis. Of the 248 implants with periodontitis, 34 (13.7%) were stage 1, 65 (26.1%) were stage 2, 61 (24.5%) were stage 3, and 89 (35.7%) were stage 4; 82 (32.9%) had grade A, 108 (43.4%) had grade B, and 59 (23.7%) had grade C. Periodontal disease was found to be positively correlated with peri-implant PD, PI, CBL, presence of suppuration, and the presence of peri-implantitis (p<0.05). Implants with gingivitis showed lower PD, PI, CBL, suppuration, and peri-implantitis (p<0.05). However, no significant difference was found between the groups in GI, BOP, and MR (p>0.05). At the implant level, the severity of periodontitis was positively correlated with peri-implant PD, PI, GI, BOP, CBL, suppuration, and peri-implantitis (p<0.05); the grade of periodontitis was positively correlated with PI (p<0.05). However, at the patient level, no statistically significant connection was found between the severity and grade of periodontitis and PD, PI, GI, BOP, CBL, MR, presence of suppuration, or peri-implant disease (p>0.05). Peri-implant disease was positively correlated with the adjacent tooth PD and CBL (p<0.05). Higher PD and CBL were found in the adjacent teeth of implants with peri-implantitis (p<0.05). At the implant level, the risk of peri-implantitis was 6.33 (1/0.158) times higher in periodontitis patients compared to those with gingivitis (p<0.001), and at the patient level, it was 8.59 times higher (p<0.001). A relationship between periodontal disease and peri-implant disease was found. As the periodontal condition worsens, the risk of peri-implantitis increases. To maintain peri-implant tissue health, it is crucial to ensure, preserve, and maintain a healthy periodontal condition. Keywords: Periodontal disease, Peri-implant disease, Dental implant