Peri-implantitis: effects of periodontitis and its risk factors—a narrative review

Background and Objective: Replacement of missing teeth using implant-supported restorations is a predictable therapeutic modality with reported dental implant success rates of greater than 90–95%: however, implant failures and peri-implantitis still occur. There is a myriad of causes for immediate, early, and late dental implant failures, including the development of peri-implant diseases. This manuscript aimed to describe and discuss the causative factors and risk factors associated with dental implant failures and peri-implantitis, with an emphasis on the relationship of periodontitis and peri-implantitis. Methods: Narrative overview of the current evidence on risk factors and contributing factors of peri-implant disease, and the association between periodontitis and peri-implant disease retrieved from searches of MEDLINE, PubMed, and Cochrane databases from 1983 to 2021. Articles selected include narrative reviews, meta-analyses, and clinical trials published in English. Key Content and Findings: The current evidence obtained from through literature search incadetes that the incidence of peri-implantitis is increasing and its severity has similar risk factors to periodontitis including, but not limited to, adverse changes within the oral biofilm, uncontrolled Type-2 diabetes, and an unexplained genetic predisposition. Conclusions: Peri-implant diseases have a complex etiology and pathogenesis which parallels periodontitis. Both have mutual risk factors/indicators including a dysbiosis of the biofilm, poor compliance with maintenance, enhanced inflammatory responses, smoking and diabetes. However, peri-implant diseases have other unique risk factors, including role of residual cement, peri-implant hard and/or soft tissue deficiencies, prosthetic designs, and potential for novel microbial pathogens.