MANAGEMENT OF PERI-IMPLANTITIS: A LITERATURE REVIEW ON DIAGNOSIS, THERAPY, AND LONG-TERM MAINTENANCE

Peri-implantitis is a biologically mediated, inflammatory disease that undermines the long term survival of dental implants by causing progressive bone loss within osseointegrated fixtures. Although implant-supported prostheses have achieved more than 90% long-term survival, prevalence of peri-implantitis continues to increase, with about 22% of patients developing the disease within a decade of implant placement. The current evidence-based review literature discussed modern strategies for diagnosis, treatment, and long-term management of peri-implantitis. The disease is a multi factorial effect of interaction among microbial biofilms, host immune response, genetic susceptibility, and iatrogenic variables. Diagnosis is confirmed on the basis of a combination of clinical parameters and sophisticated modalities such as cone-beam computed tomography, MMP-8 biomarker assays, and microbial PCR analysis. Treatment depends on the stage of the disease: early peri-implantitis can be managed non-surgically by mechanical debridement, antiseptics, and lasers, whereas advanced disease most commonly requires resective or regenerative surgical interventions based on defect morphology. The Cumulative Interceptive Supportive Therapy (CIST) protocol is an evidence-based clinical strategy for intervention. Emerging technologies such as antibacterial surface coatings, photodynamic therapy, and artificial intelligence augmented diagnostics have the potential to enhance clinical outcomes. Yet, long-term success is dependent significantly on organized maintenance such as three-month recall visits, professional biofilm control, and radiographic surveillance. This review emphasizes the value of incorporating conventional and innovative therapies into a stage-specific, prevention-based model for optimizing peri-implant health and preventing implant loss.