Periâ implantitis

Abstract

ObjectivesThis narrative review provides an evidenceâ based overview on periâ implantitis for the 2017 World Workshop on the Classification of Periodontal and Periâ Implant Diseases and Conditions.MethodsA literature review was conducted addressing the following topics: 1) definition of periâ implantitis; 2) conversion from periâ implant mucositis to periâ implantitis, 3) onset and pattern of disease progression, 4) characteristics of periâ implantitis, 5) risk factors/indicators for periâ implantitis, and 6) progressive crestal bone loss in the absence of soft tissue inflammation.Conclusions1)Periâ implantitis is a pathological condition occurring in tissues around dental implants, characterized by inflammation in the periâ implant connective tissue and progressive loss of supporting bone.2)The histopathologic and clinical conditions leading to the conversion from periâ implant mucositis to periâ implantitis are not completely understood.3)The onset of periâ implantitis may occur early during followâ up and the disease progresses in a nonâ linear and accelerating pattern.4a)Periâ implantitis sites exhibit clinical signs of inflammation and increased probing depths compared to baseline measurements.4b)At the histologic level, compared to periodontitis sites, periâ implantitis sites often have larger inflammatory lesions.4c)Surgical entry at periâ implantitis sites often reveals a circumferential pattern of bone loss.5a)There is strong evidence that there is an increased risk of developing periâ implantitis in patients who have a history of chronic periodontitis, poor plaque control skills, and no regular maintenance care after implant therapy. Data identifying â smokingâ and â diabetesâ as potential risk factors/indicators for periâ implantitis are inconclusive.5b)There is some limited evidence linking periâ implantitis to other factors such as: postâ restorative presence of submucosal cement, lack of periâ implant keratinized mucosa and positioning of implants that make it difficult to perform oral hygiene and maintenance.6)Evidence suggests that progressive crestal bone loss around implants in the absence of clinical signs of soft tissue inflammation is a rare event.