In partially edentulous patients, pre‐existing peri‐implant mucositis in conjunction with lack of adherence to SIT was associated with a higher incidence of peri‐implantitis during a 5‐year follow‐up period. The outcomes of that study yielded a 5‐year incidence of peri‐implantitis of 18.0% in the group of patients with SIT and of 43.9% in the group without SIT, respectively. The logistic regression analysis revealed that lack of adherence to SIT within the overall patient sample was significantly associated with the onset of peri‐implantitis with an odds ratio of 5.92. Hence, therapy of peri‐implant mucositis should be considered a prerequisite for the prevention of peri‐implantitis.

Materials and surface characteristics of implant components

Evidence for the influence of implant surface roughness on the incidence of peri‐implant mucositis in humans is limited. A 12‐month comparative analysis in humans between machined titanium abutments (Ra = 0.2 μm) and highly polished ceramic abutments (Ra = 0.0 6 μm) indicated that further reduction in surface roughness had no impact on bleeding on probing (BOP) scores. A study in humans investigated the association between abutment surfaces of varying roughness and the early inflammatory response of the peri‐implant mucosa. Although a statistically significant difference among patients was observed with respect to biofilm accumulation on the abutment surfaces and inflammatory cells, no association was observed between the inflammatory response and abutment surface roughness after an observation period of 4 weeks.

Compared with implants and abutments made of titanium, more beneficial properties in terms of biocompatibility have recently been claimed for implants and abutments made of zirconium dioxide (ZrO₂). It has to be noted, however, that in clinical studies no significant differences in BOP scores or slightly higher BOP scores were reported around ZrO₂ compared with titanium abutments.