Mesial-Distal Patterns of Alveolar Bone Loss in Periodontitis and Peri-Implantitis: A Comparative Radiographic Study.

Background/

Objectives

Periodontitis and peri-implantitis are inflammatory conditions associated with progressive loss of supporting bone, but they differ in tissue architecture, biological response, and disease progression. Conventional radiographic assessment often reports bone loss as a global value, which may overlook site-specific mesial-distal differences. This study aimed to compare mesial and distal radiographic bone loss around natural teeth affected by periodontitis and dental implants affected by peri-implantitis, with a focus on quadrant 1.

Methods

This retrospective comparative CBCT-based radiographic study analyzed 128 within-patient paired tooth/implant observations in quadrant 1. Mesial and distal bone loss values were recorded separately for natural teeth and corresponding implant sites. Each pair included one natural-tooth site and one implant site from the same patient, matched by comparable anatomical position and surface. Paired-samples t-tests were used, and mean differences were calculated as implants minus natural teeth. Given the multiple site-specific comparisons, p-values were interpreted as unadjusted exploratory findings.

Results

Statistically significant differences were observed only on the mesial surface of anterior implants. Mesial bone loss was significantly greater around implants than natural teeth for central incisors (8.30 ± 3.31 mm vs. 4.90 ± 1.78 mm; mean difference = 3.39 mm; p = 0.004), lateral incisors (8.12 ± 3.57 mm vs. 4.94 ± 2.82 mm; mean difference = 3.18 mm; p = 0.028), and canines (5.99 ± 3.12 mm vs. 4.42 ± 1.26 mm; mean difference = 1.57 mm; p = 0.018). No statistically significant differences were observed for distal surfaces or posterior tooth/implant positions.

Conclusions

Within the limitations of this quadrant-specific retrospective radiographic analysis, peri-implant bone loss showed a surface- and position-dependent distribution, with greater mesial bone loss around anterior implants. Separate mesial and distal assessment may provide additional value for periodontal and peri-implant monitoring.