{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T12:04:47Z","timestamp":1790597087896,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Periodontal Research"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To systematically evaluate the available evidence regarding the association between peri\u2010implantitis and systemic inflammatory biomarkers and\/or systemic diseases, and to assess whether peri\u2010implantitis treatment influences systemic inflammatory burden. Particular attention was given to the methodological limitations of the available evidence and the potential role of residual confounding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic review and meta\u2010analysis were conducted in accordance with PRISMA guidelines. Electronic searches were performed in MEDLINE, Embase, Scopus, and Web of Science from inception to December 2025, and updated in April 2026. Observational studies comparing systemic inflammatory biomarkers and\/or presence of systemic diseases between individuals with and without peri\u2010implantitis, as well as interventional studies evaluating the impact of any peri\u2010implantitis treatment on the systemic inflammatory burden, were included. Random\u2010effects meta\u2010analyses were performed using Hedges'\n                      <jats:italic>g<\/jats:italic>\n                      (standardized mean difference).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 2399 records screened, 21 studies were included in the qualitative synthesis. Fourteen observational studies evaluated systemic inflammatory biomarkers, three randomized clinical trials assessed the effect of peri\u2010implantitis treatment on systemic outcomes, and four observational studies investigated associations with systemic diseases. Comparative meta\u2010analysis demonstrated significantly higher conventional CRP concentrations in patients with peri\u2010implantitis than in healthy implant controls (Hedges'\n                      <jats:italic>g<\/jats:italic>\n                      \u2009=\u20093.73; 95% CI: 0.63\u20136.83;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), although heterogeneity was considerable (\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200999%). In contrast, no significant differences were observed for high\u2010sensitivity CRP (hsCRP) (Hedges'\n                      <jats:italic>g<\/jats:italic>\n                      \u2009=\u2009\u22120.29; 95% CI: \u22120.61 to 0.04;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.09;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20092%), IL\u20106, TNF\u2010\u03b1, IL\u201010, or IL\u20101\u03b2. Evidence regarding systemic diseases was limited and heterogeneous, precluding quantitative synthesis. Interventional studies suggested modest and predominantly short\u2010term reductions in selected inflammatory biomarkers following peri\u2010implantitis treatment, whereas consistent improvements in systemic metabolic outcomes were not demonstrated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Current evidence suggests that patients with peri\u2010implantitis may exhibit higher circulating conventional CRP concentrations in some observational studies. However, this finding should be interpreted cautiously given the substantial heterogeneity of the pooled analysis, the absence of significant differences for high\u2010sensitivity CRP, and the limited control of major confounding factors, in particular previous or concomitant periodontitis and other shared inflammatory and metabolic risk factors. Consequently, it remains uncertain whether peri\u2010implantitis represents an independent source of systemic inflammation or rather reflects a susceptible host phenotype characterized by shared inflammatory and metabolic risk factors. Well\u2010designed longitudinal and interventional studies are required before clinically meaningful systemic implications can be established.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jre.70167","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T11:54:23Z","timestamp":1790596463000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Systemic Impact of Peri\u2010Implantitis: A Systematic Review"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1611-5884","authenticated-orcid":false,"given":"Antonio","family":"Li\u00f1ares","sequence":"first","affiliation":[{"name":"Periodontology Unit, Faculty of Odontology University of Santiago de Compostela  Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4326-6741","authenticated-orcid":false,"given":"Stephane","family":"Kerner","sequence":"additional","affiliation":[{"name":"Department of Periodontics, School of Dentistry Loma Linda University  Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9251-513X","authenticated-orcid":false,"given":"Juan","family":"Blanco","sequence":"additional","affiliation":[{"name":"Periodontology Unit, Faculty of Odontology University of Santiago de Compostela  Santiago de Compostela Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2525-8529","authenticated-orcid":false,"given":"Eduardo","family":"Montero","sequence":"additional","affiliation":[{"name":"Section of Graduate Periodontology, Faculty of Dentistry University Complutense of Madrid  Madrid Spain"},{"name":"ETEP (Etiology and Therapy of Periodontal and Peri\u2010Implant Diseases) Research Group, University Complutense  Madrid Spain"},{"name":"Department of Periodontology, Institute of Odontology, the Sahlgrenska Academy at University of Gothenburg  Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5717-3274","authenticated-orcid":false,"given":"Maria Clotilde","family":"Carra","sequence":"additional","affiliation":[{"name":"Department of Translational Medicine, Faculty of Odontology University of Ferrara  Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.17-0739"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jre.12562"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s42255-019-0100-5"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0501.1996.070303.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/JPER.21-0338"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1235155"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1466417"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/prd.12532"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fdmed.2026.1774378"},{"key":"e_1_2_10_11_1","unstructured":"G. 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