PERI-IMPLANTITIS MANAGEMENT: CURRENT THERAPIES AND FUTURE PERSPECTIVES

Peri implantitis is a biofilm associated inflammatory disease characterized by progressive peri-implant bone loss and represents a growing clinical concern as dental implant therapy becomes increasingly prevalent.Despite high implant survival rates,peri implantitis affects a substantial proportion of implant patients and is associated with complex interactions between microbial biofilms, host immune responses, implant surface characteristics, and patient-related risk factors. This review provides a comprehensive overview of the etiology, diagnosis, and contemporary management strategies for peri implantitis.Conventional non surgical therapies,including mechanical debridement and adjunctive antimicrobial approaches, remain first-line interventions but demonstrate limited effectiveness in moderate to advanced disease due to restricted access to contaminated implant surfaces.Surgical therapies, encompassing resective and reconstructive approaches, offer improved infection control and pocket reduction,although long-term predictability remains variable. Regenerative strategies, particularly guided bone regeneration combined with bone grafts and biologic modifiers such as recombinant human platelet-derived growth factor-BB and enamel matrix derivative, show promise in contained defect morphologies but remain technique-sensitive. Emerging adjunctive strategies, including advanced biomaterials, implant surface engineering, probiotics, and host-modulation therapies, aim to enhance antimicrobial efficacy, modulate inflammation, and promote peri-implant tissue regeneration.