Peri-implantitis — ORE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

HardPeriodontologyPeri-implantitisORE Part 1

A 59-year-old patient with an implant-retained crown placed five years ago has bleeding on probing, suppuration and a 7 mm peri-implant pocket. Baseline radiographs showed crestal bone at the first thread; current periapical imaging shows progressive crater-like bone loss. Plaque control is poor. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Peri-implantitis

The patient meets diagnostic criteria for peri-implantitis: bleeding on probing, suppuration, probing depth of 7 mm (≥5 mm threshold), and progressive crater-like bone loss on radiographs (≥2 mm from baseline). Peri-implant mucositis is excluded because it presents with inflammation only—absent progressive bone loss; the stem explicitly documents radiographic bone loss. Retrograde peri-implantitis would require endodontic pathology or coronally exposed implant threads driving infection retrograde, neither of which is described. Cementoblastoma is a non-implant pathology and incompatible with the clinical presentation. Abutment screw loosening alone cannot account for progressive crater-like bone loss in the presence of suppuration and poor plaque control; secondary bone loss requires active infection. Poor oral hygiene is a known risk factor for progression from mucositis to peri-implantitis.

Reference: SDCEP Prevention and Treatment of Periodontal Disease (2024), https://www.periodontalcare.sdcep.org.uk/guidance/dental-implants/treatment-of-peri-implant-mucositis/; 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions (Schwarz F, Derks J, Monje A, Wang HL. J Periodontol. 2018;89(Suppl 1):S267-S290)