CLINICAL DIAGNOSIS AND EVIDENCE-BASED MANAGEMENT OF PERI-IMPLANT MUCOSITIS AND PERI-IMPLANTITIS

Abstract

Peri-implant mucositis and peri-implantitis are the most prevalent biological complications associated with dental implants, posing a significant threat to long-term implant survival. With the increasing global use of implant therapy, standardized diagnostic criteria and evidence-based management strategies have become essential. This narrative review aims to summarize the current evidence regarding the clinical diagnosis and evidence-based management of peri-implant mucositis and peri-implantitis, with emphasis on epidemiology, risk factors, pathophysiology, and preventive strategies. A comprehensive literature search was conducted using PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar for studies published between 2010 and 2025. Keywords included “peri-implant mucositis,” “peri-implantitis,” “diagnosis,” and “management.” Consensus reports, randomized controlled trials, clinical studies, and systematic reviews were prioritized. Peri-implant mucositis is a reversible inflammatory condition confined to soft tissues, whereas peri-implantitis involves progressive marginal bone loss. Epidemiological data report implant-level prevalence of mucositis ranging from 29%–43% and peri-implantitis from 9%–22%. Major risk factors include history of periodontitis, poor plaque control, smoking, diabetes, residual cement, and inadequate maintenance. Diagnosis relies on bleeding on probing, probing depth assessment, and radiographic evaluation of crestal bone levels. Non-surgical therapy is effective for mucositis, while peri-implantitis often requires surgical intervention. Structured supportive implant therapy significantly reduces disease progression. Early detection, risk factor modification, and adherence to evidence-based therapeutic protocols are critical for preventing disease progression and improving long-term implant outcomes. Continued research is required to standardize treatment protocols and optimize regenerative strategies.