The rate of peri‐implantitis observed in this study at 10 years, agreed with that described by Bragger et al. and Karoussis et al. in which peri‐implantitis occurred in 15.4% of the implants after a mean observation period of 10 years. Simonis et al. (2010) reported a prevalence of 16.9% of peri‐implantitis after an observation period of 10 to 16 years.

The study of de Waal et al. described a prevalence of peri‐implantitis among implants ranged from 0% to 3.4% after an observation period of 5 years and from 5.8% to 16.9% after an observation period of 10 years.

The survival rate found in the present study among implants reported similar values after longer periods to Roos‐Jansaker et al., where the overall survival rate was 95.7%. Several other longitudinal studies have reported survival rates of ≈ 90% to 95% over periods of 5 to 10 years. Roccuzzo et al. obtained similar results at the implant level with an implant survival rate for moderate and severe periodontal compromised patients of 96.9% and 97.1%, respectively.

According to Roos‐Jansaker et al., it is important to reiterate that the clinical condition of the remaining implants must also be considered to describe the outcome of implant treatment more accurately.

A limitation in our study is the not verified compliance to daily oral hygiene. Also, the absence of a negative control group can be considered a limitation.

The authors noted that patients often regard implant prostheses as a dentist‐provided tool, and therefore, they tend to hold the clinician responsible for any complications that can occur over the years of implant function. So, patients should be clearly informed with written informed consent outlining the increased chances of developing peri‐implant complications over a period of >5 years. All patients treated with implant prosthetic rehabilitation should be considered predisposed to peri‐implant disease and consequently enrolled in a structured supportive peri‐implant care program (SPT); in this way the peri‐implant biological complication can be intercepted early and treated as soon as possible and with less surgical invasiveness and greater predictability. This program aims not to cure but to intercept.