Peri‐implant diseases: diagnosis and risk indicators

Abstract

Background: Peri‐implant diseases include peri‐implant mucositis, describing an inflammatory lesion of the peri‐implant mucosa, and peri‐implantitis, which also includes loss of supporting bone. Methods: A literature search of the Medline database (Ovid), up to 21 January 2008 was carried out using a systematic approach, in order to review the evidence for diagnosis and the risk indicators for peri‐implant diseases. Results: Experimental and clinical studies have identified various diagnostic criteria including probing parameters, radiographic assessment and peri‐implant crevicular fluid and saliva analyses. Cross‐sectional analyses have investigated potential risk indicators for peri‐implant disease including poor oral hygiene, smoking, history of periodontitis, diabetes, genetic traits, alcohol consumption and implant surface. There is evidence that probing using a light force (0.25 N) does not damage the peri‐implant tissues and that bleeding on probing (BOP) indicates presence of inflammation in the peri‐implant mucosa. The probing depth, the presence of BOP, and suppuration should be assessed regularly for the diagnosis of peri‐implant diseases. Radiographs are required to evaluate supporting bone levels around implants. The review identified strong evidence that poor oral hygiene, a history of periodontitis and cigarette smoking, are risk indicators for peri‐implant disease. Future prospective studies are required to confirm these factors as true risk factors.