Influence of rheumatoid arthritis on peri-implant diseases: A longitudinal retrospective clinical and radiographic evaluation.

Background: To investigate the effect of rheumatoid arthritis (RA) on the incidence of peri-implantitis (PI) and peri-implant mucositis (PIM).

Methods: Radiographic and clinical chart reviews were conducted to measure the probing depth (PD), bleeding on probing, and marginal bone loss (MBL) around the implants to diagnose peri-implant diseases based on the 2017 workshop classification. Values were recorded at the baseline (T0) to the last available chart and radiograph (T1). Maintenance compliance was evaluated. Cases were followed longitudinally to detect the incidence of PI and PIM. Various potential confounders were controlled, including the total radiographic follow-up time, chart-based follow-up time, number of maintenance visits, implant dimensions, history of periodontitis, bone graft, restoration angle, emergence, smoking, and diabetes mellitus. Chi-square and Mann-Whitney tests evaluated categorical and continuous differences. Generalized estimating equations with a Tweedie distribution were applied. Binary logistic regression ascertained the odds ratio for binary outcomes.

Results: A total of 101 patients (50 RA and 51 non-RA) with 124 implants were investigated. The mean follow-up period for the implants was 5.38 ± 2.22 years. Implant survival rate was high at 96%. The RA group demonstrated a significantly higher PI (p = 0.024), while the non-RA group showed a significantly higher PIM (p < 0.001). No significant differences were observed between both groups in implant survival and MBL.

Conclusion: Compared to the non-RA group, RA patients demonstrated a similar incidence of MBL and implant survival rates and a significantly lower incidence of PIM; however, there was a significantly higher incidence of PI.

Plain language summary: In this study, we investigated the condition of dental implants in 50 patients with rheumatoid arthritis (RA) compared to 51 healthy controls over 5 years. Assessments from initial treatment to the last follow-up visit included reviewing patient records and radiographs for signs of bleeding, probing depth, and bone loss. These measures helped diagnose peri-implantitis (PI) and peri-implant mucositis (PIM) based on the 2017 periodontal disease classification. The findings revealed a high implant survival rate in both groups (96%) with no significant difference in bone loss. However, the RA group showed a significantly higher incidence of PI than the healthy group that demonstrated PIM.