This lecture addresses different aspects of the controversial topic of "peri-implantitis".
Once an implant achieves “osseointegration” clinicians have assumed that these implants will remain symptom-free forever. Indeed the description of a “steady state” seems to confirm this belief.
However, observations of soft and hard tissue changes adjacent to dental implants have been made. Clinicians have suggested that these observations are similar to those associated with periodontal disease.
Despite these observations there are many who believe that peri-implantitis can not be compared to a "periodontal" disease adjacent to a dental implant. In fact, review of current literature that addresses this disease process would suggest that the management of this problem using similar technology for the management of periodontal disease may not be successful with implants.
The concept of insufficient osseointegration, a condition in which the bone to implant contact is not sufficient to maintain long-term implant survival, may more appropriately describe the long term, albeit, low level of failure to maintain osseointegration.