Impact of Periodontitis Grading on Peri-Implant Clinical and Bone Health: A 60-Month Prospective Study

June 25, 2026 updated by: Renato Casarin, University of Campinas, Brazil

Impact of Periodontitis Grading on Clinical and Bone Peri-Implant Health: Longitudinal, Prospective, 60-Month Follow-Up Study

This prospective cohort study evaluated the effect of periodontitis grading on peri-implant clinical and radiographic outcomes over a 60-month follow-up. Fifty-five partially edentulous patients were classified into three groups according to periodontal status: generalized aggressive periodontitis (Grade C), generalized chronic periodontitis (Grade B), and no history of periodontitis. A total of 92 implants (tissue- or bone-level) were placed and restored with single crowns, followed by biannual supportive periodontal therapy.

Peri-implant clinical parameters (probing depth, clinical attachment level, plaque index, and bleeding on probing), marginal bone level changes, peri-implantitis incidence, and implant survival were assessed up to 60 months after prosthetic loading.

The objective was to determine whether periodontal history and grading influence long-term peri-implant outcomes under maintenance therapy.

Study Overview

Status

Completed

Conditions

Detailed Description

This prospective cohort study was conducted to evaluate the long-term influence of a history of periodontitis on peri-implant clinical and radiographic outcomes in partially edentulous patients. Patients were classified according to their periodontal status into three groups: generalized aggressive periodontitis (currently classified as Grade C periodontitis), generalized chronic periodontitis (Grade B periodontitis), and individuals without a history of periodontitis.

A total of 55 patients received 92 dental implants, either tissue-level or bone-level, placed in healed sites and restored with single screw-retained crowns. All patients were enrolled in a structured supportive periodontal therapy program and were followed for 60 months after prosthetic loading.

Peri-implant and periodontal health were assessed longitudinally using clinical parameters (probing depth, clinical attachment levels, plaque accumulation, and bleeding on probing) as well as radiographic evaluation of marginal bone level changes. Assessments were performed at multiple time points throughout follow-up to monitor tissue stability and disease occurrence.

The primary aim of the study was to compare peri-implant outcomes among patients with different periodontal backgrounds and to determine whether a history and severity of periodontitis influence long-term implant success and disease incidence under strict maintenance conditions. Secondary outcomes included evaluation of marginal bone remodeling, incidence of peri-implantitis, and implant survival over time.

Study Type

Observational

Enrollment (Actual)

70

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Patients with or without a history of periodontitis were included in the study

Description

Inclusion Criteria:

  • Age ≥ 18 years.
  • Previous diagnosis of aggressive periodontitis, chronic periodontitis, or no history of periodontitis.
  • Completion of periodontal treatment at least 1 year before study enrollment.
  • Enrollment in supportive periodontal therapy.
  • Plaque Index < 20% at study onset.
  • Bleeding on Probing < 20% at study onset.
  • Presence of at least one single edentulous space with adjacent teeth.
  • Sufficient bone and soft tissue volume for implant placement without the need for reconstructive procedures.

Exclusion Criteria:

  • Systemic conditions that contraindicate implant surgery.
  • Use of systemic antimicrobial therapy within 6 months before implant placement.
  • Untreated or uncontrolled aggressive periodontitis.
  • Untreated or uncontrolled chronic periodontitis.
  • Pregnancy or breastfeeding.
  • Need for bone grafting or soft tissue grafting procedures.
  • Current smokers or former smokers.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
GAP Group
Patients with a history of generalized aggressive periodontitis, rehabilitated with dental implants.
GCP Group
Patients with a history of generalized chronic periodontitis, rehabilitated with dental implants.
PPH Group
Periodontally healthy patients or Patients with no history of periodontitis (no site with probing depth > 3mm and bleeding on probing < 20%)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Marginal bone level changes around dental implants evaluated radiographically.
Time Frame: Over a 60-month follow-up period.
Primary Outcome
Over a 60-month follow-up period.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Peri-implant probing depth (PPD) at follow-up visits
Time Frame: Over a 60-month follow-up period
Secondary Outcome Measure
Over a 60-month follow-up period
Bleeding on probing (BoP) around implants
Time Frame: 60 months follow-up
60 months follow-up
Implant survival rate
Time Frame: 60 months follow-up
60 months follow-up

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

University of Campinas, Brazil

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2011

Primary Completion (Actual)

June 1, 2017

Study Completion (Actual)

January 1, 2019

Study Registration Dates

First Submitted

June 22, 2026

First Submitted That Met QC Criteria

June 25, 2026

First Posted (Actual)

June 26, 2026

Study Record Updates

Last Update Posted (Actual)

June 26, 2026

Last Update Submitted That Met QC Criteria

June 25, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 0015.0.167.0000-10

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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