Risk indicators for peri-implantitis - a narrative review.

This review addresses possible risk indicators for peri-implantitis. The authors state that plaque accumulation, a history of periodontitis, smoking, excess cement and lack of supportive therapy should all be considered risk indicators, but the scientific data for some is limited and the strength also varies.

 

Buildup of plaque around implants is associated with the development of peri-implant mucositis, which may eventually develop into peri-implantitis. To control plaque accumulation, self-performed oral hygiene is of great importance. The presence of a subgingival pathogenic microbiota with a predominance of anaerobic species is considered a risk indicator for peri-implant disease. In partially edentulous subjects, newly inserted implants can be colonized by microorganisms from adjacent teeth; the natural teeth may act as reservoirs for these pathogens. Periodontopathic bacteria have been suggested a risk indicator for peri-implant mucositis. Excess of cement is also considered a risk indicator through triggering an inflammatory response.

The above described factors are local risk factors, but there is also a group of general risk indicators investigated in this review. There is support that patients with a history of periodontitis are more likely to develop peri-implantitis. The support for genetic trait as a risk indicator is divergent, but it may have an impact on the inflammatory response and the development of peri-implantitis.

Smoking cannot, due to insufficient data, be identified as a risk factor for peri-implantitis, but should be considered a risk indicator. Regarding the connection between peri-implantitis and general diseases, like cardiovascular diseases and diabetes mellitus, evidence is limited, but there might be a relation. Participating in a structured maintenance program improves the outcome of the implant treatment; the patient’s motivation to attend supportive care visits and to perform adequate oral hygiene are both factors to consider.

From the article we can conclude that the etiology for peri-implantitis is complex.