Periimplantitis - definition, aetiology and risks

A considerable amount of successfully integrated dental implants develop inflammation leading to secondary implant failure or even implant loss. There are several key pieces of evidence that the formation of a pathogenic microflora around the neck of the implant is the primary cause for inflammation. It can affect exclusively the periimplant mucosa or also involve parts of the supporting bone. Based on these observations inflammatory conditions around dental implants have been classified into different entities. Correct diagnosis is indispensable for planning an appropriate treatment and has to be based on well defined clinical and radiographic parameters. Apart from the bacterial infection several systemic or local conditions, i.e. smoking or a history of periodontitis, have been suggested as etiologic risk factors that influence the individual susceptibility to periimplant inflammation. This contribution shall present the current knowledge on the pathogenesis of the different disease entities, compile unambiguous diagnostic criteria and describe the classification for periimplant diseases.