Mario Roccuzzo

Aim To present the 20‐year clinical outcomes of tissue‐level implants in partially edentulous patients previously treated for periodontitis and in periodontally healthy patients (PHP). Material and Methods The original population consisted of 149 partially edentulous patients consecutively enrolled in a private specialist practice and divided into three groups: PHP, moderately periodontally compromised patients (mPCP) and severely PCP (sPCP). After successful completion of periodontal/implant therapy, patients were enrolled in an individualized supportive periodontal care (SPC) programme. Results Eighty‐four patients rehabilitated with 172 implants reached the 20‐year examination. During the observation time, 12 implants were removed (i.e., 11 due to biological complications and 1 due to implant fracture), leading to an overall implant survival rate of 93% (i.e., 94.9% for PHP, 91.8% for mPCP and 93.1% for sPCP [ p = .29]). At 20 years, PCP compliant with SPC did not present with significantly higher odds of implant loss compared with PHP compliant with SPC ( p > .05). Conversely, PCP not compliant with SPC experienced implant loss with odds ratio of 14.59 (1.30–164.29, p = .03). Conclusions Tissue‐level implants, placed after comprehensive periodontal therapy and SPC, yield favourable long‐term results. However, patients with a history of periodontitis and non‐compliant with SPC are at higher risk of biological complications and implant loss.