Periodontitis and periimplantitis: one and the same?

Research shows that the same anaerobic, gram-negative pathogens are present in the periodontal and implant pocket or crevice. The implants in a partially edentulous case are probably more at risk due to the bacteria being more pathogenic and a seeding mechanism from the tooth pocket to the implant crevice. In the face of a normal microbial flora, retrograde periimplantitis or radiographic bone loss without gingival changes may be due to trauma because of overloading, loading too soon, and/or loading in a lateral direction. Finally, the combination of an infective process (periimplantitis) and noninfective or traumatic process (retrograde periimplantitis) will result in rapid osseous destruction and, possibly, loss of the implant fixture(s).