Polymeri A, Loos B G, Aronovich S, Steigmann L, Inglehart M R. Risk factors, diagnosis and treatment of peri-implantitis: a cross-cultural comparison of U.S. and European periodontists' considerations. J Periodontol 2021; doi: 10.1002/JPER.21-0010. Online ahead of print.

U.S. and European periodontists' considerations concerning risk factors, diagnosis and management of PI were evidence-based, but differences can inform future educational efforts.

The study aimed to compare U.S. vs. European periodontists' considerations of risk factors, diagnostic criteria and management of peri-implantitis (PI). Three hundred and ninety-three periodontists from the U.S. and 100 periodontists from Europe responded to anonymous surveys. Compared to U.S. periodontists, European respondents were younger, more likely to be female and placed fewer implants per month. Poor oral hygiene, history of periodontitis and smoking were considered as very important risk factors by both groups. European periodontists rated poor oral hygiene and history of periodontitis as more important and implant surface, occlusion and presence of keratinised tissue as less important than U.S. periodontists did. Both groups rated clinical probing, radiographic bone loss, and presence of bleeding and suppuration as important diagnostic criteria. They rated implant exposure/mucosal recession as relatively less important, with U.S. periodontists giving higher importance ratings than European periodontists. Both groups nearly always used patient education, plaque control and mechanical debridement when treating PI. U.S. periodontists were more likely to use antibiotics, lasers, allograft and regenerative approaches, but less likely to use resective surgery.