Peri-implantitis: a systemic burden for our patients

Peri-implantitis-an increasingly prevalent chronic inflammatory disease-has been linked not only to peri-implant bone destruction and implant failure, but also to systemic inflammation and chronic inflammatory diseases. Accumulating evidence suggest that peri-implant inflammation can contribute to a sustained systemic low-grade inflammatory state characterized by elevated inflammatory mediators, like interleukin (IL)-6 and C reactive protein, episodic bacteremia, and metabolic alterations. This persistent inflammatory burden has been associated with distal organ dysfunction, including cardiovascular and renal complications, and neuroinflammatory processes implicated in cognitive decline and neurodegeneration. In parallel, implant-supported rehabilitation and long-term maintenance has been linked to surrogate markers of cognitive resilience, whereas treatment of peri-implant diseases aimed at reducing local inflammation may, at the same, be associated with the improvement of systemic inflammatory markers. This concise review synthesizes mechanistic and clinical evidence that peri-implantitis is not only an oral disease but also a systemic health modifier, highlights current knowledge gaps, and outlines priorities for research and clinical practice.