There is evidence to suggest that patients with history of periodontitis are not necessarily at risk of losing their implants prematurely, however they may be at a higher risk of developing long-term peri-implant bone loss compared with patients with no history of periodontal disease.
A direct cause-effect relationship has been demonstrated between plaque and peri-implant disease with identical microflora being present around teeth and implants.
Host response is modified by many factors including genetics, systemic conditions such as uncontrolled diabetes, medication including bisphosphonates, heavy smoking and immunosuppression. Higher the host susceptibility, the more meticulous the plaque control and maintenance should be. Identification and control of co-morbidities such as diabetes forms an essential part of management of these patients.