Peri-implant disease
Distinguish peri-implant mucositis from bone-loss-associated peri-implantitis, considering previous baseline measurements and radiographs.
Understand
Peri-implant mucositis involves inflammation without progressive supporting bone loss; peri-implantitis includes bone loss. Implant probing and radiographs must be compared with a baseline.
Assess
Record bleeding, suppuration, depths, prosthesis cleansability and previous bone levels. Exclude loose components and other technical causes of symptoms.
Apply
Improve hygiene access and control risk factors; refer progressing bone loss for specialist assessment. Do not diagnose peri-implantitis from one bleeding site without baseline context.
Key distinctions
Implants lack a periodontal ligament and have a different soft-tissue interface. Probing around them is useful when performed consistently and compared with baseline records. Bleeding alone identifies inflammation but not the extent or history of bone loss. Prosthetic overcontour or residual cement can limit cleaning; maintenance planning must include both the biology and the restoration.
Think through a case
An implant bleeds on probing but the radiograph matches the baseline bone level. Consider mucositis and cleanability rather than diagnosing peri-implantitis automatically.
The distinction to remember
Do not compare a current image with an arbitrary ideal bone height when the patient's own baseline is available.
Test your recall
Why are baseline implant records valuable?
Show answer
They allow change in probing, bleeding and bone levels to be assessed.