Influence of Three-Year Peri-Implant Maintenance Compliance on Clinical and Radiographic Outcomes: A Cross-Sectional Analysis of Peri-Implant Disease Prevalence

The long-term success of dental implants depends not only on osseointegration but also on maintaining peri-implant tissue health and overall human health and wellbeing. Despite predictable survival rates, peri-implant diseases such as mucositis and peri-implantitis remain prevalent due to poor plaque control, contributing to oral infectious disease and illness. Peri-implant maintenance therapy (PIMT) is essential for disease prevention through regular monitoring and intervention, supporting public health, preventive medicine, and long-term patient wellbeing. The aim of the study was to evaluate the effect of peri-implant maintenance compliance on clinical and radiographic parameters and its influence on peri-implant disease prevalence. A cross-sectional study was conducted on 736 implants in patients with single-unit implant-supported prostheses functioning for at least three years. Participants were classified as compliers (≥ 2 maintenance visits/year) and non-compliers (no visits). Clinical parameters including plaque index (PI), gingival index (GI), peri-implant probing depth (PPD), clinical attachment level (CAL), keratinized mucosa width (KMW), and radiographic crestal bone loss (CBL) were recorded. Peri-implant conditions were diagnosed based on the 2017 World Workshop criteria. Statistical analysis was performed using SPSS v23.0, with significance set at P < 0.05. Compliers showed significantly better peri-implant parameters than non-compliers: lower PI (P < 0.001), GI (P < 0.001), and PPD (P = 0.01), along with reduced CAL (P = 0.02) and CBL (P < 0.001) and higher KMW (P < 0.001). Peri-implantitis was more prevalent among non-compliers (17.8%) compared with compliers (6.7%) (P < 0.001). Regular compliance with PIMT significantly enhances peri-implant clinical and radiographic outcomes while reducing peri-implant disease prevalence.