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Abstract
Background:Peri-implantitis is a prevalent biological complication affecting dental implants and is characterized by inflammatory destruction of peri-implant tissues and progressive peri-implant bone loss. Despite the high survival rates of implant therapy, peri-implantitis remains a major clinical challenge that may compromise long-term implant stability and survival. Objective:This systematic review aimed to evaluate current evidence regarding the classification, etiology, risk factors, clinical characteristics, treatment approaches, and prevention strategies associated with peri-implantitis. Methods:A systematic literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. Electronic databases, including PubMed, Scopus, and Web of Science, were searched for relevant studies. Clinical studies evaluating non-surgical, surgical, and regenerative treatment approaches for peri-implantitis were included. The primary outcomes assessed were changes in probing depth, bleeding on probing, radiographic peri-implant bone changes, and implant survival rates. The methodological quality and risk of bias of included studies were assessed using appropriate validated assessment tools according to study design. Results:A total of 142 records were identified, of which 55 studies met the eligibility criteria and were included in the qualitative synthesis. Non-surgical interventions demonstrated clinical benefits mainly in cases of early and moderate peri-implantitis, whereas surgical and regenerative approaches provided improved outcomes in patients with advanced peri-implant defects. Long-term supportive peri-implant maintenance was associated with reduced disease progression and improved implant stability. However, considerable heterogeneity was observed among studies regarding diagnostic criteria, treatment protocols, follow-up periods, and outcome assessment methods. Conclusion:The management of peri-implantitis requires early diagnosis, comprehensive risk-factor control, and individualized treatment strategies combining preventive measures, non-surgical therapy, surgical interventions, and supportive maintenance. Further well-designed clinical studies with standardized diagnostic criteria and outcome measures are required to establish evidence-based treatment protocols and improve long-term implant outcomes.
