Why Do Implants Fail?
Some dental implants fail. While many ideas concerning the genesis of this failure have been proposed, at present, most would argue that bacteria are strongly associated with peri-implant disease and implant loss. Numerous secondary factors have also been implicated, including a history of periodontitis, excessive occlusal forces, smoking, diabetes, operator experience, patient adherence (ie, compliance), and implant type, among others. More recently, the role of foreign bodies has been added to the list of possible etiologic factors.
Since dental implants are subject to many of the problems associated with natural teeth, periodic evaluation and maintenance are appropriate.

Peri-implant health is described as an absence of clinical signs of inflammation and bleeding on probing.

Those with healthy peri-implant tissues and gingivitis could be seen annually, while patients with a diagnosis of periodontitis should be seen more frequently.

If, in the clinician’s opinion, the generation of titanium particles is not related to the disease process, alternative methods for cleaning the implant surface can be used.

Before deciding on whether surgery is indicated for the treatment of peri-implantitis, which of the following should be considered?

In most cases, implants with less than what percentage of remaining bone contact are best removed?

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