The 2018 Consensus That Finally Defined Peri-Implant Disease

THE CONTEXT

Published in 2018 in the Journal of Periodontology, this consensus report by Berglundh and colleagues established the first universally accepted classification system for peri-implant diseases and conditions. With over 1,445 citations in just six years, it represents one of the most influential papers in modern implant dentistry. Before this landmark publication, clinicians lacked standardized criteria for diagnosing peri-implant mucositis and peri-implantitis, leading to inconsistent treatment approaches and research outcomes.

THE CONTRIBUTION

The 2017 World Workshop brought together leading periodontists and implantologists to create definitive diagnostic criteria. The paper established that peri-implant health could exist even around implants with reduced bone support, revolutionizing how we assess implant success. It clearly differentiated peri-implant mucositis (reversible soft tissue inflammation) from peri-implantitis (involving progressive bone loss), providing clinicians with concrete diagnostic markers including bleeding on probing, suppuration, and radiographic bone loss patterns.

THE LEGACY

This classification transformed implant dentistry by creating a common language for practitioners worldwide. Before 2018, studies on peri-implant disease used varying definitions, making research comparison nearly impossible. The consensus enabled evidence-based treatment protocols, improved patient communication, and established prevention strategies. It validated what many clinicians suspected - that plaque control around implants is as critical as around natural teeth.

MODERN RELEVANCE

Every current discussion about implant maintenance, recall protocols, and peri-implant therapy references this classification. The paper’s emphasis on early detection and prevention has shifted focus from treating established peri-implantitis to preventing its onset. Insurance companies now use these criteria for coverage decisions, and dental schools teach these classifications as standard curriculum. The framework continues to guide research into new diagnostic tools and treatment modalities.

This consensus didn’t just classify diseases - it elevated implant dentistry from an empirical practice to an evidence-based specialty with clear diagnostic standards.

https://doi.org/10.1002/JPER.17-0739

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