Into the Paradigm of Local Factors as Contributors for Peri-implant Disease: Short Communication

Although some systemic conditions have been associated with peri-implant disease, local contributing factors largely remain to be determined. This study aimed at evaluating, based on clinical photographs obtained from peri-implantitis treatment publications, the possible local contributing factors involved in its development based upon a survey obtained from three experienced clinicians (> 20 years of expertise). Cohen's kappa index was used to test the interexaminer reliability. "Too-buccal implant position" was the only parameter to reach almost perfect interexaminer agreement (κ = 0.81). "Thin-tissue biotype" and "minimal presence of keratinized mucosa" demonstrated moderate agreement (κ = 0.43 and κ = 0.58, respectively). The rest of the parameters studied based on clinical photographs were fair or poor. Therefore, based on this clinicians' survey, implants too buccally placed, minimal or a lack of keratinized mucosa, and thin-tissue biotype might contribute to a higher susceptibility of developing peri-implantitis. These factors must be the focus of attention in future cross-sectional studies on the incidence of peri-implant diseases.