Peri‐implantitis

Schwarz, Frank; Derks, Jan; Monje, Alberto; Wang, Hom‐Lay

doi:10.1111/jcpe.12954

Cited by 1,066Dental 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 Clinical Periodontology

DOI 10.1111/jcpe.12954

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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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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 [12]
The sections on conversion from mucositis to peri-implantitis and poor plaque control (page unavailable) report that mucositis is assumed to precede peri-implantitis and that patients with mucositis who received regular maintenance had lower peri-implantitis incidence. This supports care at the mucositis stage, but the paper does not establish that early identification and intervention specifically are critical. (LLM, conf=0.82)
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The prevalence of peri‐implant diseases for two‐piece implants with an internal tube‐in‐tube connection: a cross‐sectional analysis of 512 implants
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Immunohistochemical analysis of soft tissues in implants with healthy and peri‐implantitis condition, and aggressive periodontitis
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Is the presence of keratinized mucosa associated with periimplant tissue health? A clinical cross-sectional analysis
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Peri-Implant Diseases May Be Associated With Increased Time Loading and Generalized Periodontal Bone Loss: Preliminary Results
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Bone reactions at implants subjected to experimental peri‐implantitis and static load
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Peri-implant Primary Squamous Cell Carcinoma: A Case Report With 5 Years' Follow-Up
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Clinical Outcomes of Peri‐Implant Peripheral Giant Cell Granuloma: A Report of Three Cases
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Removal of failed dental implants revisited: Questions and answers
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Nanointeraction: The profound influence of nanostructured and nano-drug delivery biomedical implant surfaces on cell behavior
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Peri‐implant mucositis
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Self-citation

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
ORCID: Schwarz, Frank
Monje, Alberto
Wang, Hom‐Lay
Venue: Journal of Clinical Periodontology
Publisher: Wiley
Published: 2018-06
Volume: 45
Issue: S20
Pages: S246-S266
ISSN: 0303-6979 (ISSN-L)
1600-051X
DOI: 10.1111/jcpe.12954
OpenAlex: W4211043384
Cited by: 1,066
References: 166
Citations by year: 2026: 130 · 2025: 139 · 2024: 186 · 2023: 179 · 2022: 159 · 2021: 116 · 2020: 108 · 2019: 39 · 2018: 7
FWCI: 13.00
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 19 d)
Locations: Journal Of Clinical Periodontology (publishedVersion)
PubMed (publishedVersion)
Deep Blue (University of Michigan) (submittedVersion)
Funders: 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, probing depth, histopathology, peri-implant maintenance
MeSH terms: Dental Plaque, Humans, Oral Hygiene, Stomatitis, Dental Implants, Peri-Implantitis

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