Consensus report: Peri-implant diseases and conditions

A classification for peri-implant diseases and conditions was presented. Focused
questions on the characteristics of peri-implant health, peri-implant mucositis, periimplantitis,
and soft- and hard-tissue deficiencies were addressed.
Peri-implant health is characterized by the absence of erythema, bleeding on probing,
swelling, and suppuration. It is not possible to define a range of probing depths
compatible with health; of more importance are the clinical signs of inflammation.
Peri-implant health can exist around implants with reduced bone support.The main clinical characteristic of peri-implant mucositis is bleeding on gentle probing.
Erythema, swelling, and/or suppuration may also be present. An increase in probing
depth is often observed in the presence of peri-implant mucositis due to swelling
or decrease in probing resistance. There is strong evidence from animal and human
experimental studies that plaque is the etiological factor for peri-implant mucositis.
Peri-implantitis is a plaque-associated pathological condition occurring in tissues
around dental implants, characterized by inflammation in the peri-implant mucosa and
subsequent progressive loss of supporting bone. Peri-implantitis sites exhibit clinical
signs of inflammation, bleeding on probing, and/or suppuration, increased probing
depths and/or recession of the mucosal margin in addition to radiographic bone loss.
The evidence is equivocal regarding the effect of keratinized mucosa on the longterm
health of the peri-implant tissue. It appears, however, that keratinized mucosa
may have advantages regarding patient comfort and ease of plaque removal.
Case definitions in day-to-day clinical practice and in epidemiological or diseasesurveillance
studies for peri-implant health, peri-implant mucositis, and periimplantitis
were introduced. The proposed case definitions should be viewed within
the context that there is no generic implant and that there are numerous implant
designs with different surface characteristics, surgical and loading protocols. It is recommended
that the clinician obtain baseline radiographic and probing measurements
following the completion of the implant-supported prosthesis.