Peri-implant mucosal pressure injury (PIMPI): a proposed descriptive clinical presentation following implant-supported prosthesis delivery— a case report

Pressure-associated peri-implant mucosal injuries remain poorly described in the literature and lack standardized terminology or validated diagnostic frameworks. This report describes a clinically observed peri-implant mucosal injury pattern following delivery of an implant-supported fixed dental prosthesis, in which prosthetic soft-tissue compression was considered a possible contributing factor. The term peri-implant mucosal pressure injury (PIMPI) is proposed as a provisional descriptive clinical term intended to facilitate clinical recognition and future investigation of this presentation. Methods The patient presented with pain and peri-implant mucosal complication following delivery of a screw-retained implant-supported fixed dental prosthesis (FPD). The sites exhibited peri-implant mucosal changes, with one progressing to ulceration, sloughing, and clinical features suggestive of clinically non-viable appearing soft tissue. Treatment included pressure relief, debridement where indicated, antiseptic rinses, and fabrication of a passive-fitting restoration. Results The peri-implant mucosa healed with resolution of symptoms and restoration of function following pressure relief, debridement, and prosthetic redesign. The patient reported no discomfort during follow-up. Conclusion This case highlights a peri-implant mucosal complication observed following delivery of an implant-supported fixed dental prosthesis, in which excessive mucosal compression was considered a possible contributing factor. Symptom resolution and soft-tissue healing were achieved following pressure relief, debridement of clinically non-viable appearing tissue, and prosthetic redesign. However, the absence of histopathological, microbiological, pressure, and perfusion assessments limits causal interpretation. Further clinical and biologic studies are required to better characterize this presentation and clarify its relationship with peri-implant mucositis, peri-implantitis, and other prosthetic-biomechanical complications. When dental implants are restored with crowns or bridges, the surrounding soft tissues must remain healthy to maintain comfort and function. In some cases, excessive pressure from the prosthesis may contribute to irritation or injury of the soft tissues around dental implants. This report describes a patient who developed painful peri-implant soft-tissue changes shortly after placement of an implant-supported restoration. The term peri-implant mucosal pressure injury (PIMPI) is proposed as a descriptive term for this clinical presentation. The patient experienced pain, swelling, and soft-tissue breakdown after delivery of the restoration. Management included removal of the prosthesis, debridement of clinically non-viable appearing tissue, and fabrication of a new restoration with improved soft-tissue adaptation. The tissues healed uneventfully, and the patient remained comfortable during follow-up. Further research is needed to better understand this type of complication and to determine the best approaches for prevention and treatment.