In this inaugural EAO Digital Days session, Professor Alberto Fonzar teams up with host Eva Malinkovic to tackle a perennial question: if periodontal disease is the leading cause of tooth loss, can we safely replace those teeth with implants? Fonzar opens by reminding us that peri‑implant infections are far more common than once thought, carrying similar risk factors to periodontitis itself.
Illustrating lessons learned, he shares a 1995 case of a heavy smoker whose aggressive periodontitis recurred despite rigorous pocket elimination and prosthetic work, ultimately leading to implant failure within seven years. The takeaway? It’s not enough to focus solely on teeth or pockets; patient‑related factors—genetics, smoking habits and inflammatory response—must guide our decisions.
Conversely, Fonzar highlights two long‑term success stories: in one, non‑surgical therapy and strict four‑times‑a‑year recall preserved teeth with over 80% bone loss for more than 30 years; in another, combined periodontal and implant treatment yielded healthy teeth and implants after 11 years in a stage‑4 case.
His bottom line: always treat and stabilise periodontal disease before considering implants, and tailor maintenance schedules to each patient’s biological and behavioural profile. Poor compliance or unsuccessful periodontal therapy are red flags signalling that implants may do more harm than good. Ultimately, Fonzar stresses that rigorous patient management and ongoing maintenance—not just initial therapy—drive long‑term success for both teeth and implants.