Current understanding of the etiology, diagnosis, treatment, and management of peri-implant diseases: a narrative review for the consensus report of the Korean Academy of Periodontology

Abstract

Over the past few decades, dental implants have been successfully utilized to replace teeth lost due to periodontal disease and other conditions. However, similar to natural teeth, dental implants are vulnerable to inflammatory peri-implant diseases, which can compromise their long-term viability. This review aims to summarize the current understanding of peri-implant diseases and discuss effective strategies for their diagnosis, treatment, and long-term management. Evidence related to peri-implant diseases was categorized and reviewed in 4 sections: 1) definition, prevalence, and classification; 2) risk indicators and etiological factors; 3) diagnostic criteria; and 4) treatment protocols for peri-implant diseases. The prevalence of peri-implant mucositis and peri-implantitis is significant, affecting 43% and 22% of implant cases, respectively. Key risk factors include poor oral hygiene, a history of periodontitis, and systemic conditions such as diabetes and smoking. The outcomes of treatment are influenced by the design of the implant prosthesis and the condition of the surrounding soft tissue. Management strategies include: 1) non-surgical treatment for implants diagnosed with peri-implant mucositis; 2) comprehensive treatment, which involves both mechanical and chemical debridement and surgical access, for implants affected by peri-implantitis; and 3) removal of failed implants, followed by the restoration of pre-existing peri-implant bone defects. Managing peri-implant diseases necessitates a comprehensive approach, encompassing risk assessment, tailored treatment planning, and stringent maintenance protocols. Regular follow-ups and patient education are critical for preventing disease recurrence and ensure the long-term success of implant therapy.