{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:32:12Z","timestamp":1787725932125,"version":"build-2784847793"},"reference-count":42,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"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 Background<\/jats:title>\n Peri\u2010implant bone defect morphology is widely regarded as clinically relevant in the management of peri\u2010implantitis, but its actual influence on treatment outcomes remains unclear. The aim of this review was to assess how peri\u2010implant defect morphology has been defined, assessed, and analyzed in relation to the clinical, radiographic, and disease resolution outcomes following peri\u2010implantitis treatment.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A systematic review was performed including human clinical studies on nonsurgical and\/or surgical peri\u2010implantitis treatment that reported peri\u2010implant defect morphology, included at least 10 treated implants, evaluated outcomes at a minimum of two time points, and presented at least 12\u2009months of follow\u2010up. Extracted data focused on morphology definitions and assessment methods, treatment characteristics, and morphology\u2010related analyses of treatment outcomes. The primary outcome was the influence of peri\u2010implant defect morphology on clinical, radiographic, and disease\u2010resolution outcomes following peri\u2010implantitis treatment.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Thirty\u2010five studies were included in the qualitative synthesis. Marked heterogeneity was observed across study design, peri\u2010implantitis definitions, morphology descriptions, therapeutic protocols, and outcome measures. Morphology was assessed mainly by periapical radiographs and intra\u2010surgical evaluation, whereas three\u2010dimensional imaging was uncommon and rarely used for baseline defect characterization. Although all included studies reported morphology to a degree sufficient for eligibility, only a minority incorporated it into analytical models, subgroup comparisons, regression analyses, or morphology\u2010stratified outcome interpretation. When morphology was analyzed and reported, the approaches were inconsistent in describing the features of the peri\u2010implantitis\u2010related bone defects and included formal classifications, wall configuration, intrabony component, defect depth, defect width, defect angle, and\/or number and location of missing walls. Some studies suggested more favorable outcomes in contained or circumferential defects and in narrower\u2010angle defects, particularly for radiographic fill or bone gain when non\u2010resective measures were carried out, but these findings were not consistent across investigations and were less evident for disease resolution.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Defect morphology represents a key driver in selecting the therapeutic modality to manage peri\u2010implantitis and in anticipating the degree of therapeutic response. However, the available evidence is limited by substantial heterogeneity in peri\u2010implantitis definitions, morphology assessment methods, treatment protocols, outcome measures, and disease\u2010resolution criteria, and only a minority of studies incorporated morphology into analytical models or subgroup comparisons capable of clarifying whether it truly modifies prognosis or treatment response. In general, the literature fails in assigning accurately morphological features to peri\u2010implantitis\u2010related bone defects, other than the number of residual walls.<\/jats:p>\n <\/jats:sec>\n \n Clinical Relevance<\/jats:title>\n Peri\u2010implantitis\u2010related bone configuration deserves careful consideration as part of the overall assessment of peri\u2010implantitis lesions, but current evidence does not yet support its use as a robust independent prognostic or treatment\u2010modifying variable.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/prd.70081","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:04:22Z","timestamp":1787724262000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of defect morphology on the therapeutic outcomes of peri\u2010implantitis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0416-7380","authenticated-orcid":false,"given":"Fernando","family":"Su\u00e1rez","sequence":"first","affiliation":[{"name":"School of Dentistry Universidad Cat\u00f3lica de Santiago de Guayaquil (UCSG) Guayaquil Ecuador"},{"name":"Department of Periodontics The University of Iowa College of Dentistry Iowa City Iowa USA"},{"name":"Private Practice Madrid Spain"}],"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 CICOM MONJE Institute Badajoz Spain"},{"name":"Department of Periodontology Universitat Internacional de Catalunya Barcelona Spain"},{"name":"Department of Periodontology University of Bern School of Dental Medicine Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"issue":"1","key":"e_1_2_10_2_1","first-page":"S313","article-title":"Peri\u2010implant diseases and conditions: consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri\u2010Implant Diseases and Conditions","volume":"89","author":"Berglundh T","year":"2018","journal-title":"J Periodontol"},{"issue":"16","key":"e_1_2_10_3_1","first-page":"S158","article-title":"Peri\u2010implant health and disease. A systematic review of current epidemiology","volume":"42","author":"Derks J","year":"2015","journal-title":"J Clin Periodontol"},{"issue":"9","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1111\/clr.14116","article-title":"Surgical peri\u2010implantitis treatment with and without guided bone regeneration. 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A randomized controlled trial","volume":"43","author":"Isehed C","year":"2016","journal-title":"J Clin Periodontol"},{"issue":"10","key":"e_1_2_10_19_1","doi-asserted-by":"crossref","first-page":"1202","DOI":"10.1111\/clr.14466","article-title":"Long\u2010term treatment outcomes of peri\u2010implantitis reconstructive therapy: 7\u2010year survival and success of a randomized clinical trial","volume":"36","author":"Isler SC","year":"2025","journal-title":"Clin Oral Implants Res"},{"issue":"4","key":"e_1_2_10_20_1","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1111\/cid.13358","article-title":"Impact of peri\u2010implant keratinized mucosa width on the long\u2010term reconstructive outcomes of peri\u2010implantitis: a retrospective analysis with a follow\u2010up up to 10\u2009years","volume":"26","author":"Isler SC","year":"2024","journal-title":"Clin Implant Dent Relat Res"},{"issue":"1","key":"e_1_2_10_21_1","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1177\/0022034515610056","article-title":"Reconstruction of peri\u2010implant osseous defects: a multicenter randomized trial","volume":"95","author":"Jepsen K","year":"2016","journal-title":"J Dent Res"},{"issue":"3","key":"e_1_2_10_22_1","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1111\/clr.14385","article-title":"A 10\u2010year follow\u2010up of reconstructive treatment of peri\u2010implantitis using mineralized dehydrated allograft and resorbable membrane: a retrospective case series","volume":"36","author":"La Monaca G","year":"2025","journal-title":"Clin Oral Implants Res"},{"issue":"6","key":"e_1_2_10_23_1","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1111\/clr.13256","article-title":"Regenerative surgical therapy for peri\u2010implantitis using deproteinized bovine bone mineral with 10% collagen, enamel matrix derivative and doxycycline\u2010a prospective 3\u2010year cohort study","volume":"29","author":"Mercado F","year":"2018","journal-title":"Clin Oral Implants Res"},{"issue":"4","key":"e_1_2_10_24_1","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1034\/j.1600-0501.2001.012004287.x","article-title":"Treatment of peri\u2010implantitis by local delivery of tetracycline. 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peri\u2010implantitis: a randomized controlled trial","volume":"94","author":"Monje A","year":"2023","journal-title":"J Periodontol"},{"issue":"6","key":"e_1_2_10_31_1","doi-asserted-by":"crossref","first-page":"2199","DOI":"10.1007\/s00784-017-2310-0","article-title":"Vancomycin and tobramycin impregnated mineralized allograft for the surgical regenerative treatment of peri\u2010implantitis: a 1\u2010year follow\u2010up case series","volume":"22","author":"Nart J","year":"2018","journal-title":"Clin Oral Investig"},{"issue":"11","key":"e_1_2_10_32_1","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1111\/clr.13651","article-title":"Surgical treatment of peri\u2010implantitis defects with two different xenograft granules: a randomized clinical pilot study","volume":"31","author":"Polymeri A","year":"2020","journal-title":"Clin Oral Implants Res"},{"issue":"10","key":"e_1_2_10_33_1","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1111\/jcpe.12986","article-title":"Surgical treatment of peri\u2010implantitis lesions with or without the use of a bone substitute\u2010a randomized clinical trial","volume":"45","author":"Renvert S","year":"2018","journal-title":"J Clin Periodontol"},{"issue":"8","key":"e_1_2_10_34_1","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1111\/clr.13628","article-title":"Implant survival after surgical treatment of peri\u2010implantitis lesions by means of deproteinized bovine bone mineral with 10% collagen: 10\u2010year results from a prospective study","volume":"31","author":"Roccuzzo M","year":"2020","journal-title":"Clin Oral Implants Res"},{"issue":"10","key":"e_1_2_10_35_1","doi-asserted-by":"crossref","first-page":"1209","DOI":"10.1111\/clr.13818","article-title":"Reconstructive treatment of peri\u2010implantitis infrabony defects of various configurations: 5\u2010year 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defect configuration on the clinical outcome following surgical regenerative therapy of peri\u2010implantitis","volume":"37","author":"Schwarz F","year":"2010","journal-title":"J Clin Periodontol"},{"issue":"1","key":"e_1_2_10_39_1","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1111\/j.1600-051X.2007.01168.x","article-title":"Two\u2010year clinical results following treatment of peri\u2010implantitis lesions using a nanocrystalline hydroxyapatite or a natural bone mineral in combination with a collagen membrane","volume":"35","author":"Schwarz F","year":"2008","journal-title":"J Clin Periodontol"},{"issue":"3","key":"e_1_2_10_40_1","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1111\/j.1708-8208.2009.00264.x","article-title":"Regenerative treatment of peri\u2010implantitis bone defects with a combination of autologous bone and a demineralized xenogenic bone graft: a series of 36 defects","volume":"14","author":"Wiltfang J","year":"2012","journal-title":"Clin 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