Peri-implantitis—Is it mainly a clinician-initiated complication of implant therapy?

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dc.contributor.authorChen, Stephen T
dc.contributor.authorMonje, Alberto
dc.contributor.authorStrauss, Franz J
dc.contributor.authorSchwarz, Frank
dc.contributor.authorRoccuzzo, Andrea
dc.contributor.authorSailer, Irena
dc.contributor.authorTarnow, Dennis
dc.contributor.authorLambert, France
dc.contributor.authorJovanovic, Sascha
dc.contributor.authorBuser, Daniel
dc.coverage.spatialReino Unido
dc.date.accessioned2026-08-14T16:46:32Z
dc.date.available2026-08-14T16:46:32Z
dc.date.issued2026-06-08
dc.description.abstractThe high prevalence of peri-implantitis is concerning, with a growing consensus that the majority of cases are complications initiated by clinician-related errors rather than classic pathology. A primary predisposing factor for peri-implantitis is exposure of the micro-rough implant surfaces to the peri-implant sulcus after treatment. Objectives: To identify surgical/prosthetic factors causing micro-rough surface exposure and advocate for prevention and evidence-based protocols. Materials and Methods: This paper reviews evidence linking surgical and prosthetic errors to micro-rough surface exposure to the sulcus and subsequent peri-implantitis development. Results: Surgical factors for surface exposure include malposition, avascular necrosis, and incomplete bone regeneration of peri-implant defects. Prosthetic factors include cement remnants and wide prosthetic emergence angles. Clinician-influenceable co-factors—including patient compliance, history of periodontitis, uncontrolled systemic factors/habits, lack of keratinized mucosa, prosthetic misfit, overcontoured/uncleansable prostheses, failure to detect early bone loss or mucosal changes, and inadequate maintenance—contribute to the initiation and progression of peri-implantitis once micro-rough surfaces are exposed. Conclusions: Most peri-implantitis cases are preventable complications. Professional education and research must prioritize identifying clinician-related errors and adherence to foundational treatment principles. This requires a paradigm shift toward a complication-based model of peri-implantitis. Clinical Relevance: To reduce the risk of peri-implantitis, clinicians should avoid clinical errors that lead to exposure of the micro-rough implant surface. Hybrid surface designs and subcrestal micro-rough surface placement should be considered as safety buffers. Success depends on meticulous diagnostics and planning, proper surgical/prosthetic execution, cleansable prosthesis design, and proactive maintenance to detect early bone loss and soft tissue changes.
dc.identifier.citationPeriodontology 2000 (2026) pp. 1–32
dc.identifier.doihttps://doi.org/10.1111/prd.70051
dc.identifier.issn0906-6713
dc.identifier.issne1600-0757
dc.identifier.orcidhttps://orcid.org/0000-0002-2280-8480
dc.identifier.other42253157
dc.identifier.urihttps://hdl.handle.net/20.500.12254/7703
dc.language.isoen
dc.publisherJohn Wiley & Sons Inc.
dc.rightsAtribución-NoComercial-CompartirIgual 3.0 Chile (CC BY-NC-SA 3.0 CL)
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/cl/
dc.subjectclinician‐related errors
dc.subjecthybrid implant design
dc.subjectiatrogenic complications
dc.subjectmicro‐rough implant surfaces
dc.subjectperi‐implantitis
dc.subjectprosthodontic errors
dc.subjectsurgical errors
dc.titlePeri-implantitis—Is it mainly a clinician-initiated complication of implant therapy?
dc.typeArticle
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