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Abstract
Background:Peri-implant diseases, including peri-implant mucositis and peri-implantitis, affect a substantial proportion of dental implant recipients and represent a major challenge for the long-term maintenance of implantsupported rehabilitation. Early identification of patients at risk of progression from reversible peri-implant mucositis to destructive peri-implantitis remains a significant clinical and diagnostic challenge. Objective: To map the available evidence regarding biomarkers detected in saliva and peri-implant crevicular fluid (PICF) in peri-implant mucositis and peri-implantitis, and to identify molecular markers potentially associated with disease progression. Materials and Methods:A scoping review was conducted according to PRISMA-ScR guidelines (2018). Electronic searches were performed in PubMed/MEDLINE, Scopus, Web of Science, the Cochrane Library, and Google Scholar for studies published from 2000 - 2026. Eligible studies included human clinical investigations reporting quantitative analysis of biomarkers in saliva and/or peri-implant crevicular fluid (PICF) with appropriate comparison groups. In vitro studies, non-quantitative reports, and duplicate publications were excluded. A total of 31 studies met the inclusion criteria and were included in the final qualitative synthesis. Data were analyzed narratively, and biomarker patterns were summarized descriptively. Results: The 31 included studies consistently reported elevated levels of pro-inflammatory and bone-resorptionrelated biomarkers in peri-implantitis. In peri-implant crevicular fluid, IL-1β, TNF-α, IL-6, MMP-8, and RANKL, as well as an increased RANKL/OPG ratio, were the most frequently associated markers of disease activity. Transition from peri-implant mucositis to peri-implantitis was commonly associated with increased IL-17A, decreased IL-1 receptor antagonist (IL-1Ra), activation of matrix metalloproteinases, and markers of bone turnover such as CTX-I. Salivary biomarkers demonstrated lower diagnostic specificity compared to PICF; however, combined biomarker approaches, particularly IL-1β and MMP-8 panels, showed moderate diagnostic performance for peri-implantitis detection. Conclusion:Titanium remains the gold standard for dental implants because of its superior long-term survival, mechanical reliability, and extensive scientific validation. Zirconia implants represent a promising esthetic and metal-free alternative, particularly in anterior regions and selected clinical situations. Nevertheless, additional longterm studies are required to confirm their biomechanical reliability and long-term predictability.
