Should we really care about peri-implantitis? Can it be successfully treated?

Replacing a patient's lost teeth is nowadays considered to be as important as obtaining a good esthetic outcome and maintaining implants in adequate health and function. The literature shows that as the number of dental practices where implants are placed increases, the cases of infection and loss of implants associated with infection increase.

The oral cavity harbors a diverse microbial community, which colonizes different locations and is present in both hard and soft tissues. Therefore, there is a potential for infection due to this bacterial biofilm. A positive relationship has been established between adequate oral hygiene and prevention of peri-implant diseases. It has been speculated that peri-implant tissues may have a lower capacity of response against external aggressions due to a number of anatomic differences when compared with teeth. It is therefore extremely important to control risk factors and establish and adequate plaque control in order to prevent peri-implant diseases from occurring around dental implants.

In the first part of this chapter the reader will be guided through the main steps of a proper and accurate diagnosis. Different methods, techniques, and aspects of diagnosis are clarified. Peri-implantitis is multifactorial in nature, and assessment of risk factors is explained. The last part of this chapter discusses chemical, nonsurgical and surgical treatment of peri-implantitis lesions. Studies both in humans and animals lead the authors to suggest treatment protocols for different situations.

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