Clinical Decision Making for Primary Peri‐Implantitis Prevention: Practical Applications

Focused Clinical Question When planning dental implant therapy, what risk‐reduction strategies allow practitioners to select patients, sites, and restorative plans that decrease the incidence of peri‐implant disease? Summary With a marked increase in the number of patients receiving dental implants to treat partial or complete edentulism, it follows that the prevalence of peri‐implant mucositis and peri‐implantitis have increased. Risks associated with implant therapies may vary based upon underlying local, environmental, surgical, patient, prosthetic, and fixture‐related factors. Furthermore, an emphasis on preventative measures and maintenance should be undertaken to avoid development and progression of peri‐implant diseases. Thorough risk assessment, proper treatment planning, and early diagnosis and intervention are critical in the absence of definitive data of long‐term success of treatments for peri‐implant condition. Given the difficulty in intervention once peri‐implantitis is established, identification of risk factors and development of treatment plans to address those factors before dental implant therapy is critical to the long‐term health and success of dental implants. Conclusions A patient‐centered, evidence based approach to dental implant treatment planning to reduce the risk for peri‐implantitis should be undertaken. Systematic diagnosis of disease state(s) and evaluation of the etiologic and modifying risk factors for peri‐implant diseases can yield more optimal outcomes to reduce peri‐implantitis rates.