Predictors of Peri-Implantitis Severity: A Cross-Sectional Analysis

Eswar Kandaswamy, Nicolas Lobo, Vinayak Joshi, Vivek Math

 

Background: Peri-implantitis severity is influenced by combination of patient, site, and prosthetic factors. This cross-sectional study evaluated demographic, clinical, site-level, and radiographic predictors of peri-implantitis severity, categorized by radiographic bone loss (RBL) as Mild (<25%), Moderate (25–50%), and Severe (>50%).

Results: In 90 patients (mean age 65 yrs; 53 females) with 167 affected implants, peri-implantitis severity was 11% mild, 68% moderate, and 21% severe. At implant level, molars exhibited maximum disease severity and deeper PD than anterior implants, while premolars and molars showed higher maximum and mean PD. Longer time in function was associated with worse outcomes, including higher severity, increased bone loss, and greater %RBL. BoP correlated positively with both maximum and mean PD. A crown-to-implant ratio <1 was associated with greater RBL, and implants placed in preserved and non-preserved sockets exhibited greater bone loss than GBR-treated sites. Maxillary implants showed slightly lower maximum bone loss than mandibular implants. At the patient level, tobacco/vaping and older age were associated with more severe disease.

Conclusion: Peri-implantitis severity is driven by age, tobacco/vaping, anatomic location, time in function, BoP and prior history of grafting supporting risk‑stratified surveillance and targeted interventions to limit progression to severe peri-implantitis.