Definitions
The 2017 World Workshop of the American Academy of Periodontology and the European Federation of Periodontology set the current definitions.1
| Condition | Definition |
|---|---|
| Peri-implant health | No redness, bleeding on probing, swelling or pus1 |
| Peri-implant mucositis | Inflammation of the soft tissue; the main sign is bleeding on gentle probing; caused by plaque1 |
| Peri-implantitis | Plaque-associated inflammation of the tissue around the implant with progressive loss of supporting bone1 |
The AAP describes mucositis as gum inflammation with no bone loss, and peri-implantitis as inflammation plus deterioration of the bone supporting the implant.2
How common
A systematic review by Derks and Tomasi estimated weighted mean prevalence across 11 studies.3
| Condition | Weighted mean prevalence | Range across studies |
|---|---|---|
| Peri-implant mucositis | 43 percent | 19 to 65 percent |
| Peri-implantitis | 22 percent | 1 to 47 percent |
The wide ranges reflect different case definitions between studies.3 Prevalence of peri-implantitis rose with time in function.3
Risk factors and signs
The AAP lists these risk factors: previous gum disease, poor plaque control, smoking and diabetes.2 Signs include red or tender gums around the implant and bleeding when brushing.2
Excess cement under a crown is another factor.4 In one clinical study, excess cement was associated with peri-implant disease in 81 percent of cases.4
Treatment
The AAP states that early mucositis may be reversed, while peri-implantitis generally requires surgical treatment.2 The European Federation of Periodontology's S3 guideline (2023) sets out interventions for prevention and treatment.5
Prevention
The EFP guideline states that prevention starts when implants are planned, placed and loaded.5 Once implants are in function, it recommends a structured supportive care program with periodic checks of the tissue around the implants.5 The 2017 World Workshop recommends baseline x-ray and probing records when the restoration is completed.1
General information about dental implants. Treatment decisions are made with a licensed dentist.
Sources
- Berglundh T et al. Peri-implant diseases and conditions: consensus report of workgroup 4 of the 2017 World Workshop. J Periodontol 2018. pubmed.ncbi.nlm.nih.gov
- American Academy of Periodontology: Peri-Implant Diseases. perio.org
- Derks J, Tomasi C. Peri-implant health and disease: systematic review of current epidemiology. J Clin Periodontol 2015. pubmed.ncbi.nlm.nih.gov
- Wilson TG Jr. Excess cement and peri-implant disease. J Periodontol 2009. pubmed.ncbi.nlm.nih.gov
- Herrera D et al. Prevention and treatment of peri-implant diseases: EFP S3 level clinical practice guideline. J Clin Periodontol 2023. pubmed.ncbi.nlm.nih.gov
