Comparative Assessment of Clinical and Radiographic Parameters in Periodontal and Peri-Implant Tissues

Abstract

Background: Periodontal and peri-implant tissues are vulnerable to biofilm-associated inflammation, yet peri-implant tissues may exhibit greater destructive changes because of distinct structural and vascular characteristics. Objective: To compare clinical and radiographic parameters of inflammation in periodontitis and peri-implantitis and to evaluate associations with oral hygiene practices and dental attendance patterns among adult dental attendees in Karachi, Pakistan. Methods: A cross-sectional comparative study was conducted among 300 adults attending tertiary dental hospitals. Periodontal assessment included probing pocket depth, clinical attachment loss, bleeding on probing, and plaque status, while peri-implant assessment included peri-implant probing depth, bleeding on probing, and standardized radiographic marginal bone loss. Oral hygiene practices and dental attendance patterns were recorded using structured questionnaires. Group comparisons and multivariable logistic regression were performed in SPSS (version 25) to identify independent predictors of destructive inflammatory breakdown. Results: Periodontitis-only was present in 162/300 (54.0%), peri-implantitis-only in 58/300 (19.3%), and both conditions in 46/300 (15.3%). Peri-implantitis-only demonstrated greater probing depth (5.1 ± 1.1 vs 4.2 ± 0.9 mm; p < 0.01), higher bleeding on probing (62.1% vs 46.7%; p < 0.01), and greater marginal bone loss (2.4 ± 0.9 vs 1.6 ± 0.7 mm; p < 0.001). Poor oral hygiene (adjusted OR 2.64; 95% CI 1.58–4.42) and irregular dental visits (adjusted OR 1.89; 95% CI 1.12–3.17) independently predicted inflammatory tissue breakdown. Conclusion: Peri-implantitis is associated with more severe inflammatory and radiographic compromise than periodontitis, and modifiable behaviors—plaque control and regular maintenance attendance—remain central targets for prevention.