Emerging Issues Associated With Peri-implant Disease

The biologic complication of peri-implantitis threatens the survival of dental implants that have successfully integrated and are in function. A list of seven risk factors associated with this disease was generated in 2006 at the Sixth European Workshop on Periodontology. These factors were based on the prevailing literature. Since then, modifications to this list have been considered whereby some of the original items suggested to be associated with periimplantitis would be deleted, while, in light of evidence-based information, newer, emerging risks may be included. A common theme seems to be that many of these factors can be associated with an inflammatory "dysbalance" tipping the scale toward ongoing bone loss beyond that considered physiologic modeling or remodeling. This article aims to highlight some of these emerging items with the hope that a strategy toward prevention or early detection and treatment may be employed, rather than waiting and requiring potentially extensive surgical procedures or implant removal.