Prosthetic Impact on Peri-Implantitis and How to Prevent it

Peri-implantitis is a treatment-related complication with a biofilm-mediated pathogenesis. Several studies have demonstrated that the progression from peri-implant mucositis to peri-implantitis can be effectively managed by supportive implant therapy. However, the impact of implant prostheses on the evaluation of peri-implant tissues, the control of biofilm by oral hygiene and professional prophylaxis as well as the impact of cement or other prosthetic materials on peri-implant inflammation receive little attention. This report will consider prosthesis factors, abutment factors, and cement factors in the evaluation, management and prevention of peri-implantitis. The existing literature clearly indicates that mechanical disruption of dysbiotic biofilm is central to the prevention and management of peri-implantitis. Thus, prosthetic factors that enable or enhance biofilm formation or preclude its mechanical disruption may contribute to the progression of peri-implant mucositis to peri-implantitis. Unfortunately, many of the prosthetic factors that negatively impact peri-implant tissue health are the result of improper implant placement decisions. Both the surgical planning and prosthetic execution of therapy must be addressed in efforts to reduce the risk of peri-implantitis. Keywords: Peri-implantitis, oral hygiene, prosthesis, restorative space, cement