Introduction
Although a classification of peri-implant diseases and conditions was addressed for the first time in the 2017 World Workshop, definitions of peri-implant diseases had previously been presented at several editions of the EFP’s European Workshop on Periodontology. But the term “definition” has often provoked misunderstanding. There is a clear need to distinguish between a disease definition and a case definition. Disease definitions are descriptive and present the typical characteristics of the disease, whereas case definitions should provide the clinical guidelines for diagnosis (i.e. how to assess the condition). At the 2017 World Workshop on Periodontology, Working Group 4 presented case definitions and addressed focussed questions on the characteristics of peri-implant health, peri-implant mucositis, and peri-implantitis. The most important part of the case definitions is finding bleeding or suppuration on probing (BoP) and bone loss assessed in radiographs. BoP is the key tool to distinguish between healthy and inflamed peri-implant mucosa, while bone loss is used to differentiate between peri-implant mucositis and peri-implantitis. Bone loss in this context should exceed possible crestal-bone-level changes resulting from initial bone remodelling after implant placement.
Peri-implant health, peri-implant mucositis, and peri-implantitis
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Guidance for clinicians
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