Periodontal Disease: A Contraindication for Dental Implants?

Sarana, a dental patient from Texas, asks:

I am 50 years old, and have had periodontal disease for 20 years. I also developed rheumatoid arthritis about 12 years ago. 

I want to know if I am a candidate for dental implants even though I have had periodontal disease? Can I do a bone graft under these conditions? What are the success and failure rates for dental implants and bone grafts in a person with my conditons?

23 thoughts on “Periodontal Disease: A Contraindication for Dental Implants?

  1. Dr. Fouda says:

    No, periodontal disease isn’t a contra indication for dental implants.. it os a disease of cementum (the layer that covers the root) and the ligaments.. once the tooth is removed there is no periodontal disease .. there’s bone covered with a mucous membrane so it isn’t a gingiva.
    It is more safe to extract your teeth then do the implants after 2 month.. however immediate implants can be successfuly done too.

  2. Alejandro Berg says:

    There is no real problem if you are under control.Grafting and implants will have normal rates of success if done carefully.
    good luck

  3. Jackson says:

    If you think about it…. Who are our implant patients? Those with severe periodontal or biomechanical destruction. Luckily, implants are much more worried about force factors, micromotion, etc, than the perio pathogens present in normal amounts. Sinking an implant into pus isn’t smart, but controlling the perio while you place is actually very simple and quite predicatable.
    Good Luck,


  4. Dr. Mehdi Jafari says:

    The long-term prognosis of implants is as good in partially edentulous periodontally compromised patients as has been observed in long-term studies in the general population. It has been suggested that implants placed in partially edentulous patients are more at risk for bacterial colonization with a Perio-pathogenic micro-flora emerging from the periodontal pockets around diseased teeth in the same mouth. Some clinicians believe that partially edentulous patients with titanium implants will easily be colonized by putative periodontal pathogens in contrast to fully edentulous patients. However, if a destruction of the marginal bone around the implants occurs, this does not seem to be solely related to the presence of a Perio-pathogenic microflora. It is rather the result of a complex interaction between the microorganisms and host factors, similar to what has been seen around natural teeth affected with destructive periodontitis. However, a past history of periodontitis may represent a significant risk factor for complications around implants in patients that have been treated for advanced periodontitis. Untreated periodontal disease and refractory periodontitis patients are at risk for complications and a regular maintenance program is essential to keep the periodontal and peri-implant tissues healthy.

  5. L. Scott Brooksby, DDS, DICOI says:

    While there is a lot of talk about bacterial causes of periodontal disease, after 27 years of practice, I am more and more convinced that the surface of the tooth becomes contaminated in a way that the body begins to treat the tooth as a foreign body. If this is the case, and it may or may not be, then the removal of the tooth with later replacement by an implant should be as successful as implant placement for many other reasons.

    In my opinion, implants are reasonable replacements for teeth that need periodontal treatment, root canals or in many place crowns.

  6. Dr. Mehdi Jafari says:

    Studies have yielded inconsistent answers to the question of whether susceptibility to periodontitis affects implant treatment outcome. In one systematic review, from an initial list of 2,116 papers, 547 abstracts were examined, 49 full-text arti- cles were studied, and 2 were ?nally included in the review. One study of 346 implants in 97 partially-dentate patients iden- ti?ed de?nite periodontitis and non-periodontitis groups, each of 25 subjects with respectively 100 and 92 implants. The other study, of 112 implants in 53 patients, yielded respective groups of 8 and 45 patients. At 5 yrs in the ?rst study, 7 patients lost 8 implants in the periodontitis group, and 3 control patients lost 3 implants. In the second study, just one implant was lost, in the control group. These differences were not statistically signi?cant. The only sig- ni?cant differences were that more periodontitis patients had peri-implantitis and greater peri-implant bone loss.

  7. Mary says:

    In the past I was hospitalized for MRSA. This was three and a half years ago. I have had RA for several years. I have regular dental cleanings every three to four months, and am seriously considering three dental implants in an area where one tooth is suffering resorption and another has decay well below the gum line. These teeth need to be extracted. I was wondering if I face any special challenges with the implants given my medical history. I understand that if a staff infection flares up again it can compromise areas where there is metal in the body. At the time I had the staff I was on immune suppressant medication. I am no longer on anything that dampens the immune system now or since the hospitalization. Given this fact, what are my chances for safety w/ the implants? Thanks. Mary

  8. johndds says:

    Scott Brooksby DDS wrote

    While there is a lot of talk about bacterial causes of periodontal disease, after 27 years of practice, I am more and more convinced that the surface of the tooth becomes contaminated in a way that the body begins to treat the tooth as a foreign body. If this is the case, and it may or may not be, then the removal of the tooth with later replacement by an implant should be as successful as implant placement for many other reasons.

    In my opinion, implants are reasonable replacements for teeth that need periodontal treatment, root canals or in many place crowns.


  9. johndds says:

    SeaMentum Says on another thread

    If you ask 10 dentists you’ll get ten different answers. Laser treatment is questionable at best according to published, peer-reviewed articles but some clinicians swear by it.


    You wrote that on another thread.

    Why do you continue to doubt your own results?

    I do not get it? Are you a Periolase owner or not?

    If you are not, please retract your statements!

  10. Diann Anderson says:

    I had peridontal disease lost all of my top teeth and notice that my bottom teeth begin to shift have a few teeth left on bottom will have a bridge for eight center teeth and the sides I will have top teeth I have seven implants which the Dentist says that he only need four to do a denture to stay in place during that period of time my bite is off causing my right cheekbone to shift out a little will this correct my bite once I get the dentures set into place in my mouth?

  11. Jamie Nelson says:

    I have advance periodontal disease and have been fighting this disease for 20 yrs. I am schedule for more flap surgery and a bone graft soon. I know we should try to keep our original teeth however I would like to know when is it acceptable to start thinking about mini dental implants(upper & lower)or snap-on dentures.

  12. neild says:

    I am a 33 year old man and have periodontitis! In my upper jaw i have 7 teeth left,that are not in a very good condition(loose and full of gaps.I have been considering having my remaining teeth extracted and having set of implants done in my upper jaw.Is this a good idea?can anyone advise me of the best way forward to get my smile back!!

  13. Gemma says:

    I am a 27 year old with periodontitis and I am absoulutely devastated….I also have a severe crossbite which will need braces. I would like to know if I have all of my teeth extracted and have them replaced with implants…would I still need the braces? How do I get help with costs? It must be a fortune! Help!

  14. DLL says:

    Hi all

    I have a complicated question and I invite all of your thoughts!
    4 years ago I had an accident which affected my muscular skeletal system. Over this last 4 years I’ve been given various drugs to combat the pain; Diazepam 5mg, Ibuprofen 200mg (4×2 perday) Ammytriptyline 85mg perday, Co-codamol 30/500mg (4×2 perday) Tramadol 50mg x 3 per day, Celebrex 100mg x2 perday, plus a few other weaker variations.
    I’ve always been careful with my dental care, and have prided myself on having very few fillings and even had them replaced with composite as I hate the look of metal.
    I have developed periodental disease and have so far lost 1 upper and 1 lower middle molar on the left. My dentist has spotted 2 more pockets developing in the same place on the right side.
    My question is, has my medication caused or played a substantial role in this condition developing?

  15. romeo nguyen says:

    im a 33 years old male with periodontitis,that cost alot of bone lost,recently my dentist susgest that i should extract all my teeth,bone grafts and do 8 for all implants,(8 on top for 14 teeths) my question is is 8 for all implants work? are they work as well as 14 implants for 14 teeths? 2. how do do look? do they look as natual as your own teeth? 3. how long do they last? 4. what is the BEST solution for me?

  16. John H says:

    I’m under the impression that ACTIVE PD is a contraindication for dental implant placement. Of course one of the reasons you would typically get implants is because of PD, but don’t you usually get the disease under control first? e.g. by scaling and root planing, hygiene regimens, and the patients cooperation

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