Prevalence of Peri-implant Diseases: Systematic Review and Meta-Analysis

Objectives: There are few reviews discussing the prevalence of peri-implant diseases but a limited number of studies were included and selection criteria were inconsistent. By using the different selection criteria and including a large number of studies published in recent years, the prevalence of per-implant diseases and associated clinical variables were systemically reviewed and analyzed.
Methods: Electronic search of studies was conducted using MEDLINE, EMBASE and Web of Science. Publication screening, data extraction, and quality assessment were performed. The selection criteria included: 1) The articles were published in English. 2) The studies had at least average there-year follow-up period. 3) The numbers of subjects and implants in the studies had to be equal to or more than thirty. 4) The studies reported the prevalence of peri-implant diseases. Weighted mean implant based peri-implantitis (WIPI), subject based peri-implantitis (WSPI), implant based peri-mucositis (WIM), and subject based peri-mucositis (WSM) were analyzed using random-effects model.
Results: Forty-seven studies were selected. Subject-based peri-implantitis prevalence (WSPI=19.83%, 95% confidence interval (CI) [15.38, 24.27]) and peri-mucositis prevalence (WSM: 46.83%, CI: [38.30, 55.36]) were higher than implant-based peri-implantitis prevalence (WIPI=9.25%, CI [7.57, 10.93]) and peri-mucositis prevalence (WIM: 29.48%, CI: [22.65, 36.32]) respectively. Of the variables tested in the meta-regression, patient cohorts with a higher implant/subject ratio and the longer follow-up period had a greater prevalence of subject-based peri-implantitis (p-value=0.03, 0.04). Smoking was significantly associated with implant-based peri-implantitis prevalence (p-value=0.04). In subgroup analysis, the prevalence of implant-based peri-implantitis showed divergent results on different thresholds of radiographic bone level change (>2mm: 6.04%, CI: [3.88, 8.19]; ≤2mm: 10.59%, CI:[ 8.84, 12.35]).
Conclusions: Peri-implant diseases are highly prevalent. Inconsistent definition and criteria for the diagnosis of peri-implant diseases are concerns for studying the prevalence and extent of the diseases. It is time to rethink the current definitions of peri-implant diseases.