With the introduction of a new, globally standardized periodontitis classification on June 21, 2018, periimplantitis was also redefined (Berglundh et al. 2018, Schwarz et al. 2018). According to this, periimplantitis is characterized by inflammation in the periimplant connective tissue and progressive loss of supporting bone. The onset of periimplantitis is possible early on during the aftercare process.

At the histopathological level, periimplantitis shows clear differences to periodontitis. Periimplantitis has a higher potential for progression and an increased local inflammatory response in comparison. The disease progresses non-linearly and - compared to periodontitis - at an accelerated rate (Schwarz et al. 2018).

What is healthy and what is already ill?
Periimplantitis sites show clinical signs of inflammation and increased probing depths compared to baseline measurements.

However, it is not possible to distinguish healthy from diseased periimplant tissue by probing or measuring the pocket depth alone (Berglundh et al. 2018).

Periimplant mucositis is similar to gingivitis on natural teeth and is considered reversible. Early diagnosis and treatment is therefore important. However, if periimplant mucositis remains untreated, the inflammation can spread to the surrounding bone tissue, resulting in irreversible peri-implantitis, which can lead to the loss of the implant.

If it is possible to identify patients at risk reliably and at an early stage, there is a great opportunity to reduce the prevalence of periimplantitis.