Peri-Implantitis Diagnosis — ORE Part 1 MCQ

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EasyPeriodontologyPeri-Implantitis DiagnosisORE Part 1

A patient with a dental implant presents with increasing probing depths (from baseline 3 mm to now 7 mm) with bleeding on probing and suppuration. Radiographs show progressive bone loss around the implant. What is the diagnosis?

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Correct answer: A — Peri-implantitis

Explanation lettering: C = shown as B · D = shown as C · B = shown as D

Peri-implantitis is the correct diagnosis. The key discriminator is the radiographic evidence of progressive bone loss combined with inflammation (BOP, suppuration) and increased probing depth. SDCEP guidance and the 2017 World Workshop consensus define peri-implantitis precisely by these three features. Peri-implant mucositis (B) presents with identical clinical signs but is distinguished by the absence of progressive bone loss—radiographs show no bone loss. Normal peri-implant tissue (C) requires absence of inflammation and bone loss, neither of which is present here. Implant fracture (D) and retrograde peri-implantitis (E) are not supported: the patient shows ascending inflammatory peri-implant disease, not mechanical implant failure or apical pathology.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP). Prevention and Treatment of Periodontal Disease. Guidance on Examining the Peri-implant Tissues. Available at: https://www.periodontalcare.sdcep.org.uk/guidance/dental-implants/general-care-of-dental-implants/examining-the-peri-implant-tissues/