CONTEMPORARY APPROACHES IN PERI-IMPLANTITIS: FROM ETIOLOGY TO THERAPEUTIC PROTOCOL

Alina-Elena Jehac, Ovidiu Ștefănescu, Norina Consuela Forna, Doriana Agop-Forna

Introduction:Peri-implantitis is an inflammatory disease of the peri-implant tissues, associated with progressive loss of supporting bone around osseointegrated dental implants. With the increasing number of implant-prosthetic treatments, the prevalence of this condition has become a major concern in clinical dental practice. The etiopathogenesis of peri-implantitis is closely related to bacterial colonization of the implant surface, particularly by Gram-negative anaerobic species, through a mechanism comparable to that of periodontitis. Established risk factors include a history of periodontal disease, poor oral hygiene, smoking, uncontrolled diabetes mellitus, and occlusal overload.

Diagnosis is based on correlating clinical parameters—bleeding on probing, peri-implant pocket depth, and the presence of suppuration—with radiographic evidence of marginal crestal bone changes. Distinguishing peri-implant mucositis from peri-implantitis is essential for selecting an appropriate therapeutic strategy.

Sources: An electronic search was conducted using terms related to “peri-implantitis,” “therapeutic protocol,” and related concepts via PubMed and Google Scholar, prioritizing highly cited articles according to predefined inclusion and exclusion criteria, as well as review articles and the authors’ personal experiences. This review does not adhere to PRISMA guidelines nor does it include a formal risk-of-bias assessment, given its narrative format. The aim of the present study was to analyze the current literature on the treatment of peri-implantitis.

Conclusions: The current therapeutic armamentarium includes non-surgical methods (mechanical debridement, local antiseptics, systemic antibiotic therapy, Er:YAG laser treatment, photodynamic therapy) and surgical methods (resective surgery, regenerative surgery using bone grafts and membranes, implantoplasty). Recent literature supports the need for a sequential and individualized approach focused on implant surface decontamination and control of risk factors.

At present, there is no universally accepted therapeutic protocol; however, effective management of peri-implantitis requires a multidisciplinary approach and a rigorous long-term maintenance program.

DOI : 10.62610/RJOR.2025.1.18.3