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Clinical Lecturer and Honorary Consultant in Periodontology, Periodontology Unit, Centre for Host–Microbiome Interactions, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's and St Thomas' NHS Foundation Trust; Specialist Practitioner, Private Practice, London
Associate Professor in Periodontology and Implant Dentistry, Postgraduate Academic Dean, Director of Clinical Investigation and Dental Innovation Center, Institute of Dentistry, Universidad de La Frontera, Temuco, Chile; Specialist Practitioner, Private Practice, Temuco, Chile
Clinical Reader and Honorary Consultant in Periodontology, Undergraduate Periodontology Lead, Centre for Immunobiology and Regenerative Medicine, Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London; Specialist Practitioner, Private Practice, London
Consultant in Restorative Dentistry, Director of Dental Education, Royal London Hospital, Barts Health NHS Trust; Honorary Senior Lecturer, Co-Lead for DClinDent Programme in Prosthodontics, Institute of Dentistry, Queen Mary University of London; Specialist Practitioner, Private Practice, London
Professor of Periodontology and Implant Dentistry, Honorary Consultant in Periodontology, Director of Research, Director of Centre for Oral Clinical Research, Institute of Dentistry, Queen Mary University of London; Royal London Hospital, Barts Health NHS Trust; Specialist Practitioner, Private Practice, London
Peri-implantitis is a biological complication characterized by an inflammatory process affecting the soft and hard tissues around an osseo-integrated load-bearing implant. Clinically, it results in progressive bone loss, pocket formation, bleeding and/or suppuration and leads to implant loss. Although the main aetiological factor is bacterial biofilms, the clinical presentation and progression of peri-implantitis is exacerbated by several local, systemic and iatrogenic factors. Treatment protocols of peri-implantitis include various decontamination procedures of the exposed implant surface. In this two-part series, we will review the available evidence for the non-surgical and surgical management of peri-implantitis (Part 1), and then we will discuss various modalities for implant surface decontamination (Part 2).
CPD/Clinical Relevance: The pre-operative risk identification and management at both patient and site level, early diagnosis and regular supportive peri-implant care are fundamental for long term implant success and survival.
Article
A classification for peri-implant health and diseases was published in 2018 and subsequently modified in 2023 (Table 1).1,2 Peri-implant health is characterized by the absence of: erythema; bleeding on probing; swelling; and/or suppuration. However, it is not possible to define a range of probing depths compatible with health.1
BoP: bleeding on probing; S: suppuration; PPD: probing pocket depth; BL: bone levels; ID-COSM: Implant Dentistry Core Outcome Set and Measurements; IO: intra-osseous; IP: implant platform.
Peri-implant mucositis is mainly characterized by bleeding on gentle probing, a decrease in probing resistance, erythema, swelling, and/or suppuration.1 Peri-implantitis was defined as a plaque-associated pathological condition occurring in tissues around dental implants, which is characterized by inflammation and progressive loss of supporting bone.1 Peri-implantitis sites show clinical signs of inflammation, bleeding on probing and/or suppuration, increased probing depths and/or recession of the mucosal margin, in addition to radiographic bone loss.1,3
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