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Sucesso de implantes dentários em pacientes com doença periodontal: revisão narrativa
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Introdução: Nas últimas décadas, a reabilitação oral com implantes dentários tornou-se um tratamento rotineiro e eficaz para pacientes parcial ou totalmente desdentados. Os implantes endósseos apresentam elevadas taxas de sucesso a longo prazo, embora possam ocorrer complicações biológicas como a peri-implantite. A peri-implantite é uma condição inflamatória que afeta os tecidos peri-implantares e está associada a fatores de risco como a periodontite, o tabagismo, o mau posicionamento do implante e a acumulação de placa bacteriana. Entre estes, a história de periodontite tem sido amplamente estudado, embora a associação com falha do implante e peri-implantite permaneça algo inconsistente. Algumas evidências sugerem que os doentes com doença periodontal prévia apresentam um maior risco de inflamação do tecido peri-implantar e de perda óssea marginal. Apesar da previsibilidade da terapia com implantes, estes riscos realçam a importância de identificar fatores específicos do paciente que influenciam a osteointegração e os resultados a longo prazo. Uma melhor compreensão destas variáveis é crucial para melhorar os protocolos clínicos e garantir um sucesso mais previsível dos implantes. Objetivo: avaliar o sucesso de implantes dentários em pacientes com doença periodontal, nomeadamente a estabilidade dos implantes, a taxa de sobrevivência dos implantes e os fatores que influenciam diretamente o seu sucesso.
Metodologia: Para esta revisão integrativa foi realizada uma pesquisa bibliográfica realizada em bases de dados eletrónicas (PubMed, SciELO e Web of Science) recorrendo a uma query, focando em estudos publicados entre 2015 e 2025. Os artigos foram selecionados de acordo com critérios de inclusão e exclusão previamente determinados. Resultados: No global os estudos demonstram elevadas taxas de sucesso e de sobrevivência a longo prazo, variando geralmente entre 91% a 99% e 72% a 95%, respetivamente. No entanto, pacientes com história de periodontite tendem a apresentar taxas de sucesso e de sobrevivência ligeiramente inferiores em comparação com indivíduos periodontalmente saudáveis. Embora alguns estudos não tenham encontrado diferenças estatisticamente significativas entre os grupos, outros relataram um risco aumentado de falha do implante e complicações biológicas, especialmente em casos de periodontite agressiva generalizada. As taxas de peri-implantite variaram entre aproximadamente 10% a 24%, sendo a mucosite ainda mais prevalente. A maioria das falhas de implantes ocorreu nos primeiros três anos após a colocação. Os fatores que influenciam os resultados do implante incluem o estado periodontal e a gravidade da doença prévia.
Conclusão: Embora as taxas de sobrevivência dos implantes se mantenham elevadas, mesmo em doentes com antecedentes de periodontite, o sucesso a longo prazo é influenciado por fatores como a gravidade da doença e as complicações biológicas. Apesar de as diferenças de sobrevivência entre pacientes periodontalmente saudáveis e comprometidos não serem frequentemente estatisticamente significativas, as formas avançadas de periodontite estão associadas a riscos acrescidos de complicações, especialmente peri-implantite. A maioria das falhas ocorre entre os 3 e os 10 anos após a carga, enfatizando a importância do seguimento a longo prazo. De um modo geral, os implantes dentários são uma opção de tratamento fiável, mas resultados ideais exigem uma avaliação de risco individualizada e cuidados de suporte rigorosos.
Introduction: In recent decades, oral rehabilitation with dental implants has become a routine and effective treatment for partially or completely edentulous patients. Endosseous implants have high long-term success rates, although biological complications such as peri-implantitis can still occur. Peri-implantitis is an inflammatory condition affecting the peri-implant tissues and is associated with risk factors such as periodontitis, smoking, implant malposition, and plaque accumulation. Among these, a history of periodontitis has been extensively studied, although the association with implant failure and peri-implantitis remains somewhat inconsistent. Some evidence suggests that patients with prior periodontal disease are at increased risk of peri-implant tissue inflammation and marginal bone loss. Despite the predictability of implant therapy, these risks highlight the importance of identifying patient-specific factors that influence osseointegration and long-term outcomes. A better understanding of these variables is crucial to improve clinical protocols and ensure more predictable implant success. Objective: To evaluate the success of dental implants in patients with periodontal disease, namely implant stability, implant survival rate and factors that directly influence their success. Methodology: For this integrative review, a bibliographic search was performed in electronic databases (PubMed, SciELO and Web of Science) using a query, focusing on studies published between 2015 and 2025. The articles were selected according to previously determined inclusion and exclusion criteria. Results: In general, the studies demonstrate high success and long-term survival rates, generally ranging from 91% to 99% and 72% to 95%, respectively. However, patients with a history of periodontitis tend to have slightly lower success and survival rates compared to periodontally healthy individuals. Although some studies found no statistically significant differences between groups, others reported an increased risk of implant failure and biological complications, especially in cases of generalized aggressive periodontitis. Peri-implantitis rates ranged from approximately 10% to 24%, with mucositis being even more prevalent. Most implant failures occurred within the first three years after placement. Factors that influence implant outcomes include periodontal status, severity of previous disease, and the severity of the disease. Conclusion: Although implant survival rates remain high even in patients with a history of periodontitis, long-term success is influenced by factors such as disease severity and biological complications. While survival differences between periodontally healthy and compromised patients are often not statistically significant, advanced forms of periodontitis are associated with increased risks of complications, especially peri-implantitis. Most failures occur between 3 and 10 years after loading, emphasizing the importance of long-term follow-up. Overall, dental implants are a reliable treatment option, but optimal results require individualized risk assessment and rigorous supportive care.
Introduction: In recent decades, oral rehabilitation with dental implants has become a routine and effective treatment for partially or completely edentulous patients. Endosseous implants have high long-term success rates, although biological complications such as peri-implantitis can still occur. Peri-implantitis is an inflammatory condition affecting the peri-implant tissues and is associated with risk factors such as periodontitis, smoking, implant malposition, and plaque accumulation. Among these, a history of periodontitis has been extensively studied, although the association with implant failure and peri-implantitis remains somewhat inconsistent. Some evidence suggests that patients with prior periodontal disease are at increased risk of peri-implant tissue inflammation and marginal bone loss. Despite the predictability of implant therapy, these risks highlight the importance of identifying patient-specific factors that influence osseointegration and long-term outcomes. A better understanding of these variables is crucial to improve clinical protocols and ensure more predictable implant success. Objective: To evaluate the success of dental implants in patients with periodontal disease, namely implant stability, implant survival rate and factors that directly influence their success. Methodology: For this integrative review, a bibliographic search was performed in electronic databases (PubMed, SciELO and Web of Science) using a query, focusing on studies published between 2015 and 2025. The articles were selected according to previously determined inclusion and exclusion criteria. Results: In general, the studies demonstrate high success and long-term survival rates, generally ranging from 91% to 99% and 72% to 95%, respectively. However, patients with a history of periodontitis tend to have slightly lower success and survival rates compared to periodontally healthy individuals. Although some studies found no statistically significant differences between groups, others reported an increased risk of implant failure and biological complications, especially in cases of generalized aggressive periodontitis. Peri-implantitis rates ranged from approximately 10% to 24%, with mucositis being even more prevalent. Most implant failures occurred within the first three years after placement. Factors that influence implant outcomes include periodontal status, severity of previous disease, and the severity of the disease. Conclusion: Although implant survival rates remain high even in patients with a history of periodontitis, long-term success is influenced by factors such as disease severity and biological complications. While survival differences between periodontally healthy and compromised patients are often not statistically significant, advanced forms of periodontitis are associated with increased risks of complications, especially peri-implantitis. Most failures occur between 3 and 10 years after loading, emphasizing the importance of long-term follow-up. Overall, dental implants are a reliable treatment option, but optimal results require individualized risk assessment and rigorous supportive care.
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Periodontite Implantes dentários Sucesso dos implantes Sobrevivência dos implantes Periodontitis Dental implants Implant success Implant survival