Group 4 ITI Consensus Report: Risks and biologic complications associated with implant dentistry
Open accessAbstract
Objectives: The aim of Working Group 4 was to address topics related to biologic risks and complications associated with implant dentistry. Focused questions on (a) diagnosis of peri‐implantitis, (b) complications associated with implants in augmented sites, (c) outcomes following treatment of peri‐implantitis, and (d) implant therapy in geriatric patients and/or patients with systemic diseases were addressed. Materials and methods: Four systematic reviews formed the basis for discussion in Group 4. Participants developed statements and recommendations determined by group consensus based on the findings of the systematic reviews. These were then presented and accepted following further discussion and modifications as required by the plenary. Results: Bleeding on probing (BOP) alone is insufficient for the diagnosis of peri‐implantitis. The positive predictive value of BOP alone for the diagnosis of peri‐implantitis varies and is dependent on the prevalence of peri‐implantitis within the population. For patients with implants in augmented sites, the prevalence of peri‐implantitis and implant loss is low over the medium to long term. Peri‐implantitis treatment protocols which include individualized supportive care result in high survival of implants after 5 years with about three‐quarters of implants still present. Advanced age alone is not a contraindication for implant therapy. Implant placement in patients with cancer receiving high‐dose antiresorptive therapy is contraindicated due to the associated high risk for complications. Conclusions: Diagnosis of peri‐implantitis requires the presence of BOP as well as progressive bone loss. Prevalence of peri‐implantitis for implants in augmented sites is low. Peri‐implantitis treatment should be followed by individualized supportive care. Implant therapy for geriatric patients is not contraindicated; however, comorbidities and autonomy should be considered.
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Early identification and intervention at the mucositis stage is critical.
“Early identification and intervention at the mucositis stage is critical [12, 13]”
From Confidence of primary care dental practitioners in the assessment, referral and maintenance of dental implants: a cross-sectional survey in Yorkshire (2026) · cites this paper as [13]
Consensus statement 1 (§3.2.1; page unavailable) reports the prevalence of peri-implant mucositis, but does not discuss identifying or treating it early. The supportive-care recommendations (§4.3.4; page unavailable) concern monitoring and reducing peri-implantitis risks, not intervention specifically at the mucositis stage. Searches for early identification, treatment, and intervention at that stage found no passage addressing the claim. (LLM, conf=0.72)
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- Authors
- Heitz‐Mayfield, L. J., Aaboe, M., Araujo, M., Carrión, J. B., Cavalcanti, R., Cionca, N., Cochran, D., Darby, I., Funakoshi, E., Gierthmuehlen, P. C., Hashim, D., Jahangiri, L., Kwon, Y., Lambert, F., Layton, D. M., Lorenzana, E. R., McKenna, G., Mombelli, A., Müller, F., Roccuzzo, M., Salvi, G. E., Schimmel, M., Srinivasan, M., Tomasi, C., & Yeo, A.
- Affiliations
- The University of Sydney (AU)
- Private Practice Solrod Denmark
- State University of Maringa Parana Brazil
- Universidade de Santiago de Compostela (ES)
- Sapienza University of Rome (IT)
- University of Geneva (CH)
- The University of Texas at San Antonio Health Science Center (US)
- The University of Melbourne (AU)
- Kyushu Dental University (JP)
- Heinrich Heine University Düsseldorf (DE)
- New York University (US)
- Kyung Hee University School of Dentistry Seoul Korea
- University of Liège (BE)
- The University of Queensland (AU)
- Texas A&M University (US)
- Queen's University Belfast (GB)
- University of Turin (IT)
- University of Bern (CH)
- University of Gothenburg (SE)
- National Dental Centre of Singapore (SG)
- Corresponding author
- Heitz‐Mayfield, Lisa J.
- ORCID
- Venue
- Clinical Oral Implants Research
- Publisher
- Wiley
- Published
- 2018-10
- Volume
- 29
- Issue
- S16
- Pages
- 351-358
- ISSN
- 0905-7161 (ISSN-L)
- 1600-0501
- OpenAlex
- W2896709236
- Cited by
- 130
- References
- 6
- Citations by year
- 2026: 14 · 2025: 13 · 2024: 21 · 2023: 20 · 2022: 17 · 2021: 21 · 2020: 19 · 2019: 5
- FWCI
- 13.71
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Clinical Oral Implants Research (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Research Portal (Queen's University Belfast) (publishedVersion, cc-by-nc)
- Archive ouverte UNIGE (University of Geneva) (publishedVersion, other-oa)
- National University of Singapore (submittedVersion)
- BORIS (University Library Bern) (submittedVersion, cc-by-nc)
- ORBi (University of Liège) (submittedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- Open Access CRIS of the University of Bern
- Funders
- Public Health Agency (EAT/5389/17, STL/5187/15)
- Topics
- Health Sciences › Dentistry › Oral Surgery › Dental Implant Techniques and Outcomes
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Dentistry › Oral Surgery › Dental Radiography and Imaging
- Keywords
- peri-implantitis, bleeding on probing, peri-implant bone loss, implant failure, peri-implantitis treatment, periodontal maintenance, elderly patients, antiresorptive therapy, systemic disease, implant complications
- MeSH terms
- Aftercare, Alveolar Ridge Augmentation, Dental Implantation, Endosseous, Dentistry, Disease Susceptibility, Humans, Neoplasms, Periodontal Index, Recurrence, Risk Factors, Dental Implants, Prevalence, Databases, Factual, Dental Restoration Failure, Bone Density Conservation Agents, Peri-Implantitis
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