Clinical Implication of Bone Defect Morphology in Peri-implantitis Therapy

The most current data fails to elucidate the influence of the peri-implantitis-related bone morphology upon therapeutic outcomes as this has been an underreported area of clinical research. The aim of this concept paper is to provide further insight into the clinical influence of peri-implantitis lesion morphology on both the treatment approach and the likelihood for success. Numerous factors have been associated with defect configuration. Amongst them, implant axis in relation to the skeletal bony housing seems to be pivotal in selecting an effective therapeutic modality to address peri-implantitis. Considering that, a 10-stepwise approach is proposed to manage peri-implantitis. In summary, the surgical approach for managing peri-implantitis, whenever non-surgical measures have failed, must be dictated by defect configuration. Rarely does the morphology of a peri-implantitis lesion enable complete stability of a bone graft material and/or the clot. The bases for this are suboptimal implant position or a deficiency in alveolar ridge width at the time of placement. Hence, resective strategies are often essential combined with reconstructive measures, where possible, to achieve long-term successful outcomes.