Peri-implant diseases: a narrative review of etiology, diagnosis, and contemporary management strategies

The advent of dental implants in the 20th century revolutionized restorative dentistry, providing patients with a practical and aesthetically pleasing solution for tooth loss. However, this innovation has been overshadowed by the rise of peri-implant diseases, such as peri-implant mucositis and peri-implantitis, which compromise the longevity of implants and present significant challenges for clinicians. These conditions impact millions globally, with up to 65% of patients having peri-implant mucositis and some developing peri-implantitis. The economic impact is substantial, with treatment costs in the U.S. alone exceeding $3,000 per case. This review explores the historical development of peri-implant diseases, their multifactorial etiology, advancements in diagnostics, and current and emerging treatment strategies. By integrating insights from microbiology, immunology, and biomechanics, the review aims to provide a comprehensive framework for the prevention, early detection, and personalized management of these complex conditions.