Dental implant risk factors for peri-implant disease: a narrative review

Background and Objective: Dental implants have become a leading method to rehabilitate areas of missing teeth. Their success and survival rates, as well as their supporting tissues health, are influenced by various intrinsic and exogenous factors. Each year the total number of implants in function rises with more patients becoming at risk for peri-implantitis (PI). Various treatment modalities have been suggested for PI, varying from minimally invasive methods to extensive regenerative surgeries. In advanced stages of PI, implant removal and reimplantation may be required. There is little long-term data regarding the effectiveness of treatment as counter measure to assure the long-term effectiveness of dental implant therapy. It remains the responsibility of the individual clinician to understand the risk factors involved in development of PI and incorporate mitigation strategies as part of overall patient treatment. The aim of the manuscript is to review the scientific literature regarding risk factors for peri-implant disease (PID). Methods: A comprehensive review of the English literature (published between 2005 and May 2021) was conducted in MEDLINE, PubMed, Cochrane and Google Scholar databases on intra-oral and extra -oral risk factors. Key Content and Findings: Implant supported rehabilitation is a most predictable method to replace missing teeth. Both intrinsic and extrinsic factors may danger the long term success of dental implants, and should be addressed properly before, during, and after implants installation and restoration. Conclusions: PI is a major challenge for implant long-term success and longevity. Hence, it is important to understand the risk factors associated with this entity and strive to eliminate them as much as possible on the one hand and be familiar with the methods to treat and control them on the other hand. Our narrative review presents putative risk factors associated with the formation of PI. Among these are history of periodontitis, tissue phenotype, diabetes mellitus (DM), osteoporosis, bruxism, bone turnover impairment pharmaceuticals, smoking, alcohol consumption, implant structural aspects, surgical installation errors including implant mal-positioning or inadequate spacing, prosthetic restorative risk factors and oral hygiene maintenance, frequency, and plaque control.