Cited by 755Dental Implant Techniques and OutcomesOral microbiology and periodontitis researchPeriodontal Regeneration and Treatments

Peri‐implantitis

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Schwarz, Frank, Derks, Jan, Monje, Alberto, Wang, Hom‐Lay·2018·Journal of Periodontology

Abstract

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

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  1. [4]4. Journal of Clinical Periodontology 2012;39 Suppl 12:202-206.
  2. [33]33. Sanz M, Alandez J, Lazaro P, Calvo JL, Quirynen M, van Steenberghe D. Histo-pathologic characteristics of peri-implant soft tissues in Branemark implants with 2 distinct clinical and radiological patterns. Clinical Oral Implants Research 1991;2:128-134.
  3. [79]79. Hanselaer L, Cosyn J, Browaeys H, De Bruyn H. [Giant cell peripheral granuloma surrounding a dental implant: case report]. Revue Belge de Medicine Dentaire (1984) 2010;65:152-158.
  4. [117]117. Ferreira SD, Silva GL, Cortelli JR, Costa JE, Costa FO. Prevalence and risk variables for peri-implant disease in Brazilian subjects. Journal of Clinical Periodontology 2006;33:929-935.
  5. [119]119. Axelsson P, Lindhe J. Effect of controlled oral hygiene procedures on caries and periodontal disease in adults. Journal of Clinical Periodontology 1978;5:133-151.
  6. [152]152. Renvert S, Aghazadeh A, Hallstrom H, Persson GR. Factors related to peri-implantitis -a retrospective study. Clinical Oral Implants Research 2014;25:522-529.

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Authors
Schwarz, F., Derks, J., Monje, A., & Wang, H.
Affiliations
  • Goethe University Frankfurt (DE)
  • University of Gothenburg (SE)
  • University of Bern (CH)
  • University of Michigan (US)
Corresponding author
Schwarz, Frank
Venue
Journal of Periodontology
Publisher
Wiley
Published
2018-06
Volume
89
Issue
S1
Pages
S267-S290
ISSN
  • 0022-3492 (ISSN-L)
  • 1943-3670
OpenAlex
W4211093662
Cited by
723
References
166
Citations by year
2026: 53 · 2025: 72 · 2024: 99 · 2023: 132 · 2022: 132 · 2021: 102 · 2020: 89 · 2019: 38 · 2018: 6
FWCI
11.30
Type
journal article
Language
en
Open access
Locations
  • Journal of Periodontology (publishedVersion)
  • PubMed (publishedVersion)
  • Deep Blue (University of Michigan) (submittedVersion)
Funders
  • University of Michigan
  • Osteology Foundation
  • Electro Medical Systems
  • DENTSPLY Implants
  • Geistlich Pharma
  • Oral Reconstruction Foundation
Topics
  • Health Sciences › Dentistry › Oral Surgery › Dental Implant Techniques and Outcomes
  • Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
  • Health Sciences › Medicine › Urology › Periodontal Regeneration and Treatments
Keywords
peri-implantitis, peri-implant mucositis, dental implants, marginal bone loss, disease progression, risk factors, chronic periodontitis, plaque control, smoking, diabetes mellitus, keratinized mucosa, histopathology
MeSH terms
Dental Plaque, Humans, Oral Hygiene, Risk Factors, Stomatitis, Dental Implants, Alveolar Bone Loss, Peri-Implantitis

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