Risk indicators for peri-implantitis. A narrative review

Clin Oral Implants Res. 2015 Sep;26 Suppl 11:15-44. doi: 10.1111/clr.12636.


Aim: To examine the existing evidence in identifying risk indicators in the etiology of peri-implantitis.

Material and methods: A literature search was performed in MEDLINE via PubMed database of the US National Library of Medicine, for articles published until October 2014 using Medical Subject Heading search terms + free text terms and in different combinations.

Results: The microbiota associated with peri-implantitis is complex, demonstrating differences and similarities to the one seen at periodontitis sites. Plaque accumulation at dental implants triggers the inflammatory response leading to peri-implant mucositis/peri-implantitis. Individuals with a history of periodontal disease and smokers have an increased risk of developing peri-implantitis. There is some evidence to support the role of genetic polymorphism, diabetes, and excess cement as risk indicators for the development of peri-implantitis. There is also evidence to support that individuals on regular maintenance are less likely to develop peri-implantitis and that successful treatment of periodontitis prior to implant placement lowers the risk of peri-implantitis.

Conclusions: Plaque accumulation at implants will result in the development of an inflammation at implants. A history of periodontal disease, smoking, excess cement, and lack of supportive therapy should be considered as risk indicators for the development of peri-implantitis.

Keywords: biofilm; etiology; excess cement; genotype; microbiology; oral hygiene; partial edentulism; peri-implantitis; periodontitis; risk indicators; smoking; supportive periodontal therapy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Dental Cements / adverse effects
  • Dental Plaque / complications
  • Diabetes Complications
  • Humans
  • Microbiota
  • Oral Hygiene
  • Peri-Implantitis / etiology*
  • Peri-Implantitis / genetics
  • Peri-Implantitis / microbiology
  • Periodontal Diseases / complications
  • Polymorphism, Genetic
  • Risk Factors
  • Smoking / adverse effects


  • Dental Cements