Peri-implant diseases and conditions are included within the 2017 classification of periodontal and peri-implant diseases and conditions, by the European Federation of Periodontology. This classification provides definitions for diseases affecting tissues surrounding dental implants and helps guide diagnosis and management.
Peri-implant diseases occur in the tissues surrounding osseointegrated dental implants and are broadly divided into two inflammatory conditions:
Peri-implant mucositis
Peri-implantitis
(The classification also recognises peri-implant tissue health and several implant-related tissue deficiencies)
Peri-implant Health
Peri-implant health refers to the absence of clinical signs of inflammation in the tissues surrounding a dental implant.
Clinical characteristics include:
Absence of bleeding on probing (BOP)
No suppuration
Stable probing depths compared with previous measurements
No progressive radiographic bone loss following initial physiological bone remodelling after implant placement
It is important to recognise that probing depths around implants may vary depending on implant position, soft tissue thickness, and prosthetic design. Assessment should be based on changes from baseline measurements rather than absolute probing depth alone.
Peri-implant Mucositis
Peri-implant mucositis is a reversible inflammatory condition affecting the soft tissues surrounding a dental implant, without associated loss of supporting bone.
Clinical features include:
Bleeding on probing
Erythema and swelling of peri-implant mucosa
Suppuration
No progressive radiographic bone loss beyond initial remodelling
The condition is primarily caused by accumulation of bacterial plaque biofilm on implant surfaces. Similar to gingivitis around natural teeth, peri-implant mucositis is generally reversible with effective plaque control and professional debridement.
Risk factors include:
Poor oral hygiene
Irregular supportive periodontal therapy
Smoking
History of periodontitis
Poor prosthesis design that impedes cleaning
Early identification and management are important to prevent progression to peri-implantitis.
Peri-implantitis
Peri-implantitis is a plaque-associated pathological condition characterised by inflammation in the peri-implant mucosa accompanied by progressive loss of supporting bone.