Peri‐Implantitis Prevalence and Risk Indicators in Patients Seen at Periodontal Units in Malaysia: A Multicenter Cross‐Sectional Study

AIM: To determine the prevalence and identify risk indicators for peri-implant mucositis (PIM) and peri-implantitis (PI) among implant patients in Malaysian periodontal units. MATERIALS AND METHODS: This multicenter cross-sectional study included 352 patients with 647 implants (mean loading time 6.5 ± 4.0 years) across seven Malaysian states. Clinical evaluation included full-mouth plaque and bleeding scores (FMPS, FMBS), probing depth, tissue phenotype, and prosthetic condition. Peri-implant conditions were classified according to 2017 World Workshop definitions. Generalized Estimating Equation models identified risk indicators. RESULTS: Healthy was observed in 53.7% of patients and 59.7% of implants. PIM affected 36.4% of patients and 31.5% of implants; PI affected 9.9% of patients and 8.8% of implants. Bone-level implants and keratinized tissue width (KTW) < 2 mm were common risk indicators for both conditions. At patient level, FMBS ≥ 10% predicted PI (OR 2.41; 95% CI 1.19-5.05), and ≥ 3 implants were associated with PIM (OR 1.78; 95% CI 1.02-3.11). At implant level, PI was further associated with poor prosthetic condition (OR 4.94; 95% CI 2.38-10.26), splinted crowns (OR 3.48; 95% CI 1.06-11.42), and bridge restorations (OR 3.32; 95% CI 1.31-8.42). No associations were found for age, sex, smoking, or diabetes. CONCLUSIONS: Peri-implantitis affect one in ten implant patients. Due to modest sample size and wide confidence intervals, these findings are exploratory and hypothesis-generating. Potential risk indicators including elevated FMBS, reduced KTW, defective prostheses, and bone-level implants highlight the need for routine assessment of tissue phenotype and prosthetic integrity during maintenance care.