A scoping review of diagnostic techniques used for the detection of peri-implantitis around endosseous dental implants

TL;DR

This paper reviews various diagnostic methods for detecting peri-implantitis, a condition affecting dental implants, and highlights the most commonly used techniques.

Contribution

The study provides a comprehensive overview of current diagnostic approaches for peri-implantitis through a scoping review.

Findings

Imaging, microbial profiling, and biomarker analysis are key diagnostic domains for peri-implantitis.

Intraoral ultrasonography and biomarkers like IL-1β and aMMP-8 show promise for early diagnosis.

Genetic and histopathological studies also contribute to understanding and diagnosing the condition.

Abstract

Periimplant mucositis and periimplantitis are inflammatory reactions occurring around endosseous dental implants. The objective of this scoping review was to examine diagnostic techniques used to assess periimplantitis in clinical studies on human subjects.

The research question formulated was “What are the various diagnostic techniques used for detection of periimplantitis in patients who have received endosseous dental implants?” MEDLINE (PubMed), EMBASE, and SCOPUS were searched using a combined MeSH-based search strategy for studies published between 2015 to February 2025.

A total of 162 unique studies were included. Study designs, publication years, diagnostic domains, and methodological characteristics are summarized. Studies were categorized as belonging to the diagnostic domains of Imaging (n = 11), Microbial profiling (n = 57), Biomarkers in PICF/saliva (n = 28), Metabolic (n = 38), Genetic (n = 15) and Histopathology (n = 13). All studies used clinical and radiographic criteria to diagnose periimplantitis and then further assessed novel techniques and protocols for early diagnosis. Though standardized intraoral periapical (IOPA) radiograph remains the clinical standard of assessing peri implant bone loss, intraoral ultrasonography demonstrates potential utility to assess both peri implant hard and soft tissues. Microbial studies use Quantitative Polymerase Chain Reaction and Gene Sequencing techniques to identify bacterial community structures and microbial “shifts” that trigger inflammatory responses and measure therapeutic effects of treatments of established disease. Biomarkers of inflammation Interleukin-1β (IL-1β), collagen degradation enzymes active-Matrix Metalloproteinases-8 (aMMP-8) and bone turnover marker Receptor activator nuclear factor kappa b ligand (RANKL) in PICF demonstrate potential diagnostic and prognostic utility. Molecular signatures and study of small molecules were used for discovery of novel biomarkers while genetic studies assessed genetic polymorphisms increasing susceptibility to periimplantitis. Pathologic studies assessed changes in tissue architecture and correlation of shed implant particles and peri implantitis.

This scoping review identified major diagnostic domains and mapped various diagnostic tools to provide an overview of contemporary diagnostic approaches.

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