Peri-implantitis and Severity Level

Different diagnostic criteria were used for diagnosis of peri-implant diseases. The aim of this cross-sectional study was to explore prevalence of peri-implant diseases and subclassify peri-implantitis based on different levels of radiographic and clinical findings.

Two hundred patients having 655 dental implants were included in this study. In addition to clinical measurements, standard long-cone parallel technique was used to evaluate marginal bone level around implants. Following diagnosis of peri-implant diseases, peri-implantitis was further subclassified using a severity leveling in terms of marginal bone level and probing depth.

Mean age of 200 subjects was 52.8 ± 12.2 years and 63% were females. In total, bleeding on probing was present in 93% and suppuration in 27% of implants. On subject basis, 2.5% were diagnosed as healthy, 28% with peri-implant mucositis (PM), and 69.5% with peri-implantitis, whereas on implant basis, 3.6% were healthy, 36% presented PM, and 60.4% peri-implantitis. Furthermore, when severity leveling was applied, peri-implantitis prevalence changed markedly and ranged from 14.5 to 31.0% at the subject level and from 10.0 to 22.0% at the implant level. Subgingival restoration margins were observed in 70.6% of patients for implants with PM and in 44% patients for implants with peri-implantitis. Most of the implants with peri-implantitis were with platform match (71.5%).

Applying different thresholds to the peri-implantitis definition yielded different prevalence rates ranging from 10 to 31%. As no established diagnostic criteria are being used today, results from clinical studies may not reflect the true disease prevalence.