{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T16:35:50Z","timestamp":1791477350172,"version":"4.3.4"},"reference-count":251,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Periodontology 2000"],"abstract":"Abstract<\/jats:title>\n \n Aim<\/jats:title>\n The high prevalence of peri\u2010implantitis is concerning, with a growing consensus that the majority of cases are complications initiated by clinician\u2010related errors rather than classic pathology. A primary predisposing factor for peri\u2010implantitis is exposure of the micro\u2010rough implant surfaces to the peri\u2010implant sulcus after treatment.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To identify surgical\/prosthetic factors causing micro\u2010rough surface exposure and advocate for prevention and evidence\u2010based protocols.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods<\/jats:title>\n This paper reviews evidence linking surgical and prosthetic errors to micro\u2010rough surface exposure to the sulcus and subsequent peri\u2010implantitis development.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Surgical factors for surface exposure include malposition, avascular necrosis, and incomplete bone regeneration of peri\u2010implant defects. Prosthetic factors include cement remnants and wide prosthetic emergence angles. Clinician\u2010influenceable co\u2010factors\u2014including patient compliance, history of periodontitis, uncontrolled systemic factors\/habits, lack of keratinized mucosa, prosthetic misfit, overcontoured\/uncleansable prostheses, failure to detect early bone loss or mucosal changes, and inadequate maintenance\u2014contribute to the initiation and progression of peri\u2010implantitis once micro\u2010rough surfaces are exposed.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Most peri\u2010implantitis cases are preventable complications. Professional education and research must prioritize identifying clinician\u2010related errors and adherence to foundational treatment principles. This requires a paradigm shift toward a complication\u2010based model of peri\u2010implantitis.<\/jats:p>\n <\/jats:sec>\n \n Clinical Relevance<\/jats:title>\n To reduce the risk of peri\u2010implantitis, clinicians should avoid clinical errors that lead to exposure of the micro\u2010rough implant surface. Hybrid surface designs and subcrestal micro\u2010rough surface placement should be considered as safety buffers. Success depends on meticulous diagnostics and planning, proper surgical\/prosthetic execution, cleansable prosthesis design, and proactive maintenance to detect early bone loss and soft tissue changes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/prd.70051","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T10:08:54Z","timestamp":1780913334000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Peri\u2010implantitis\u2014Is it mainly a clinician\u2010initiated complication of implant therapy?"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3303-0344","authenticated-orcid":false,"given":"Stephen T.","family":"Chen","sequence":"first","affiliation":[{"name":"Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences The University of Melbourne Melbourne Victoria Australia"},{"name":"Melbourne Periodontal Specialists Balwyn Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8292-1927","authenticated-orcid":false,"given":"Alberto","family":"Monje","sequence":"additional","affiliation":[{"name":"Department of Periodontology and Oral Medicine University of Michigan Ann Arbor Michigan USA"},{"name":"Department of Periodontology Universitat Internacional de Catalunya Barcelona Spain"},{"name":"Department of Periodontology University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5832-7327","authenticated-orcid":false,"given":"Franz J.","family":"Strauss","sequence":"additional","affiliation":[{"name":"Clinic of Reconstructive Dentistry, Center of Dental Medicine University of Zurich Zurich Switzerland"},{"name":"Discipline of Periodontics, School of Dentistry, Faculty of Medicine and Health The University of Sydney Sydney New South Wales Australia"},{"name":"Faculty of Dentistry Universidad Finis Terrae Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5873-9903","authenticated-orcid":false,"given":"Frank","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Oral Surgery, Implantology and Oral Medicine Goethe University Frankfurt Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8079-0860","authenticated-orcid":false,"given":"Andrea","family":"Roccuzzo","sequence":"additional","affiliation":[{"name":"Shanghai Perio\u2010Implant Innovation Center, Institute of Integrated Oral, Craniofacial and Sensory Research, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology Shanghai Jiao Tong University, National Center of Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology Shanghai China"},{"name":"Department of Periodontology, School of Dental Medicine University of Bern Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4537-7624","authenticated-orcid":false,"given":"Irena","family":"Sailer","sequence":"additional","affiliation":[{"name":"Division of Fixed Prosthodontics and Biomaterials, University Clinic of Dental Medicine University of Geneva Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0805-5802","authenticated-orcid":false,"given":"Dennis","family":"Tarnow","sequence":"additional","affiliation":[{"name":"Implant Education Columbia University College of Dental Medicine New York New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1018-2544","authenticated-orcid":false,"given":"France","family":"Lambert","sequence":"additional","affiliation":[{"name":"Department of Periodontology and Oro\u2010Dental Surgery, Faculty of Medicine University of Li\u00e8ge Li\u00e8ge Belgium"},{"name":"Dental Biomaterial Research Unit University of Li\u00e8ge Li\u00e8ge Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sascha","family":"Jovanovic","sequence":"additional","affiliation":[{"name":"giDE Dental Institute Losa Angeles California USA"},{"name":"giDE Dental Implant Center Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3920-4257","authenticated-orcid":false,"given":"Daniel","family":"Buser","sequence":"additional","affiliation":[{"name":"School of Dental Medicine University of Bern Bern Switzerland"},{"name":"Centre for Implantology Buser and Frei Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"issue":"20","key":"e_1_2_10_2_1","first-page":"S286","article-title":"Peri\u2010implant 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