Association between peri‐implantitis and cardiovascular diseases: A case‐control study

Background This study assesses the association between peri‐implantitis and cardiovascular diseases (CVD). Methods One hundred and twenty‐eight patients with dental implants were recruited to evaluate the prevalence of peri‐implantitis in patients with or without CVD (CVD group, n = 82, control group, n = 46, respectively). Diagnosis of peri‐implantitis followed the 2017 World Workshop guidelines and the severity was defined as mild, moderate, and severe form when the radiographic bone loss (RBL) was 4 mm. Multivariable logistic regression was performed to test the association between two diseases. Results A trend of higher prevalence of peri‐implantitis defined by detectable RBL beyond the physiologic bone remodeling was found in the CVD group (64.6%) when compared with the controls (56.5%). A significant higher prevalence (48.8%) of moderate to severe peri‐implantitis was identified in CVD compared with controls(30.4%) with a significant crude association between moderate to severe peri‐implantitis and CVD (odds ratio = 2.18, 95% CI, 1.02 to 4.67; P = 0.04). The CVD group had a trend of higher prevalence of deep pockets (≥7 mm) and higher numbers of sites with bleeding on probing (>66%) when compared with controls (P > 0.05). However, after controlling for multiple confounders including age, hypertension, smoking, family history of heart attack, and periodontitis, the significant association was not found. Conclusions CVD group had significantly higher prevalence of moderate to severe peri‐implantitis (RBL ≥2 mm). The association between the two diseases did not exist after controlling multiple confounders for CVD. Future studies with a larger sample size controlling for the patient‐ and implant‐related confounders are needed to better understand the link between peri‐implantitis and CVD.