Insights into the Clinical Diagnosis of Peri-implantitis: to Probe or Not to Probe

The present review aimed at assessing the primary and secondary diagnostic tools currently used to monitor peri-implant conditions. There has been much debate on the diagnostic accuracy of clinical parameters in monitoring peri-implant conditions. Given the association between pocket depth measured around teeth and implants and the extent of microbial plaque biofilm deposits, it seems plausible for probing pocket depth to be indicative of disease progression or stability. Moreover, understanding the inflammatory nature of peri-implantitis, it seems reasonable to advocate that bleeding, erythema, tumour and suppuration are indicators of pathology. However, cautiousness must be exercised when interpreting clinical findings, since the morphology of peri-implant tissues differ significantly from the periodontal structures. The routine clinical assessment of dental implants, including probing and visual examination, may lead to the accurate diagnosis of peri-implant disorders. Nevertheless, the definitive diagnosis should be based on agreement with progressive radiographic bone loss. In fact, primary diagnostic tools seem to be highly specific for monitoring peri-implant conditions, while their sensitivity is lower compared with their use in monitoring periodontal stability.