Impact of professional experience and practice setting on clinical decision-making and anxiety in peri-implantitis management: a cross-sectional survey study

Peri-implantitis management is clinically demanding and may be accompanied by professional anxiety; however, the extent to experience level and practice setting shape treatment decisions and anxiety has not been fully clarified. Previous surveys have described clinicians’ knowledge and attitudes toward peri-implantitis, yet evidence integrating therapeutic preferences with clinician anxiety remains scarce. This study assessed Turkish periodontists’ awareness and treatment priorities for peri-implant diseases and examined the influence of professional experience, postgraduate exposure, and workplace setting on treatment selection and anxiety during severe peri-implantitis management. A cross-sectional, web-based survey was conducted between April and December 2025 among periodontology specialists in Turkey. The questionnaire collected demographic and professional characteristics, education and awareness regarding peri-implant diseases, clinical approaches to peri-implantitis, and anxiety using the Beck Anxiety Inventory (BAI). BAI scores were categorized as minimal (0–7), mild (8–15), moderate (16–25), and severe (26–63). Group comparisons were performed with chi-square tests. Multivariable binary logistic regression evaluated predictors of choosing surgical (vs. non-surgical) peri-implantitis therapy and predictors of the presence of anxiety (BAI ≥ 8). Statistical analyses were performed with IBM SPSS Statistics for Windows, Version 25.0. Data from 184 periodontists were analyzed (79.3% female; mean professional experience 14.50 ± 9.16 years). Most participants reported minimal anxiety during severe peri-implantitis management (78.3%), with mild (12.0%), moderate (6.5%), and severe anxiety (3.3%) less frequent. In regression analysis for treatment selection, private (vs. public) practice independently predicted a higher likelihood of choosing surgical modalities (OR = 2.212, 95% CI 1.171–4.177; p = 0.014). In regression analysis for anxiety, greater specialist experience was associated with lower odds of anxiety (OR = 0.839, 95% CI 0.760–0.925; p < 0.001), while gender and practice setting were not significant. Among Turkish periodontists, anxiety related to severe peri-implantitis management was generally low and decreased with increasing specialty experience. Practice setting, rather than experience or anxiety, was the key independent predictor of choosing surgical treatment, with private-sector clinicians more likely to select surgical approaches. These findings support the value of structured postgraduate exposure, continued professional development, and early-career support to strengthen confident, evidence-based peri-implantitis care across diverse practice environments.