Objective To investigate the use of peri‐implant crevicular fluid (PICF) interleukin‐1β (IL‐1β), IL‐6, tumor necrosis factor‐α (TNF‐α), and matrix metalloproteinase‐8 (MMP‐8) biomarkers in distinguishing between healthy implants (H), peri‐implant mucositis (MU), and peri‐implantitis (PI). Material and Methods Electronic using three databases (Pubmed, EMBASE, and Cochrane) and manual searches were conducted for articles published up to March 2018 by two independent calibrated reviewers. Meta‐analyses using a random‐effects model were conducted for each of the cytokines; IL‐1β, IL‐6, and TNF‐α, to analyze standardized mean difference (SMD) between H and MU, MU and PI, H and PI with their associated 95% confidence intervals (CI). Qualitative assessment of MMP‐8 was provided consequent to the lack of studies that provide valid data for a meta‐analysis. Results Nineteen articles were included in this review. IL‐1β, IL‐6, and TNF‐α, levels were significantly higher in MU than H groups (SMD: 1.94; 95% CI: 0.87, 3.35; P < .001, SMD: 1.17; 95% CI: 0.16, 3.19; P = .031 and SMD: 3.91; 95% CI: 1.13, 6.70; P = .006, respectively). Similar results were obtained with PI compared to H sites (SMD: 2.21, 95% CI: 1.32, 3.11; P < .001, SMD: 1.72; 95% CI: 0.56, 2.87; P = .004 and SMD: 3.78; 95% CI: 1.67, 5.89; P < .001, respectively). IL‐6 was statistically higher in PI than MU sites (SMD = 1.46; 95% CI: 0.36, 2.55; P = .009); while IL‐1ß increase was not significant. Despite absence of meta‐analysis, MMP‐8 show to be a promising biomarker in detection of PI in literature. Conclusion Within the limitations of this study, pro‐inflammatory cytokines in PICF, such as IL‐1ß and IL‐6, can be used as adjunct tools to clinical parameters to differentiate H from MU and PI.

Encouraging evidence is shown that ultrasound can accurately measure peri-implant tissue dimensions. Following clinical trial validations, ultrasound offers potential as a valuable tool to evaluate long-term peri-implant tissue stability without concerns of ionizing radiation and image artefacts around implants.

Background Clinical data on the restorative designs affecting the early progression of peri‐implantitis are scarce. The aim of this retrospective study was to evaluate the influence of several restorative factors (e.g., restoration emergence angle, and internal screw length/diameter) on the marginal bone loss around implants with peri‐implantitis. Methods Implants diagnosed with peri‐implantitis having 1‐ (T1) and 2‐year (T2) follow‐ups were included. In addition, within 6 months pre‐diagnosis (Tb), all cases required to have full documentation in which no evidence of peri‐implantitis was not indicated. Changes in marginal bone levels (MBLs) from Tb to T1 and from T1 to T2 were evaluated. The effect of several variables on MBLs changes was assessed via univariate and multivariate generalized estimating equations. Results Eighty‐three bone‐level implants from 65 patients were selected. The mean follow‐up before peri‐implantitis diagnosis was 99.47 ± 47.93 months. The radiographic mean marginal bone loss was 1.52 ± 1.33 mm (Tb to T1) and 0.58 ± 0.52 mm (T1 to T2). Restoration emergence angle and frequency of maintenance visits significantly affected MBLs from Tb to T1. Besides, 66.3% of the included implants’ bone levels were in a zone within 1 mm of the apical end of the internal screw at T1 and remained in this zone during the second follow‐up year. Conclusions Significant marginal bone loss occurred in the early post‐diagnosis period of peri‐implantitis, which could be affected by the restoration emergence angle. Peri‐implant MBLs were frequently located in a zone within 1 mm of the apical end of the internal screw.