From peri-implant mucositis to peri-implantitis: Incidence and risk indicators in a university dental hospital sample with up to 10 years of follow-up

OBJECTIVES: To determine the proportion of patients with peri‑implant mucositis who develop peri‑implantitis over a 1- to 10-year follow-up period, and to identify the variables associated with this progression. MATERIALS AND METHODS: A retrospective cohort study was conducted including 97 patients with 204 dental implants diagnosed with peri‑implant mucositis. Clinical and radiographic examinations were performed, and compliance with supportive peri‑implant care (SPIC) was recorded. A multilevel multinomial logistic regression model was developed to identify the predictors of disease progression. RESULTS: After a mean follow-up of 49.8 months, 23.7% of patients initially diagnosed with peri‑implant mucositis became healthy, 57.7% showed no change and remained with peri‑implant mucositis, while 18.5% progressed to peri‑implantitis. A history of periodontitis significantly increased the odds of presenting peri‑implant disease at the last follow-up appointment (p < 0.001). Conversely, regular compliance with SPIC, prostheses with an adequate design, and single-unit restorations significantly reduced the risk of progression (p < 0.001). CONCLUSIONS: Almost one fifth of patients with dental implants with peri‑implant mucositis are likely to develop peri‑implantitis after a mean follow-up of 4 years. A history of periodontitis, irregular supportive peri‑implant care and inadequate prosthetic design increase the likelihood of bone loss and progression to peri‑implantitis. CLINICAL SIGNIFICANCE: This study emphasizes the importance of regular supportive peri‑implant care and appropriate prosthetic design to prevent progression from peri‑implant mucositis to peri‑implantitis, especially in patients with a history of periodontitis.