Background: The recently introduced 2017 World Workshop on the classification of periodontitis, incorporating stages and grades of disease, aims to link disease classification with approaches to prevention and treatment, as it describes not only disease severity and extent but also the degree of complexity and an individual's risk. There is, therefore, a need for evidence‐based clinical guidelines providing recommendations to treat periodontitis.Aim: The objective of the current project was to develop a S3 Level Clinical Practice Guideline (CPG) for the treatment of Stage I–III periodontitis.Material and Methods: This S3 CPG was developed under the auspices of the European Federation of Periodontology (EFP), following the methodological guidance of the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation (GRADE). The rigorous and transparent process included synthesis of relevant research in 15 specifically commissioned systematic reviews, evaluation of the quality and strength of evidence, the formulation of specific recommendations and consensus, on those recommendations, by leading experts and a broad base of stakeholders.Results: The S3 CPG approaches the treatment of periodontitis (stages I, II and III) using a pre‐established stepwise approach to therapy that, depending on the disease stage, should be incremental, each including different interventions. Consensus was achieved on recommendations covering different interventions, aimed at (a) behavioural changes, supragingival biofilm, gingival inflammation and risk factor control; (b) supra‐ and sub‐gingival instrumentation, with and without adjunctive therapies; (c) different types of periodontal surgical interventions; and (d) the necessary supportive periodontal care to extend benefits over time.Conclusion: This S3 guideline informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective modalities to treat periodontitis and to maintain a healthy dentition for a lifetime, according to the available evidence at the time of publication.

Background: The recently published Clinical Practice Guidelines (CPGs) for the treatment of stages I–IV periodontitis provided evidence‐based recommendations for treating periodontitis patients, defined according to the 2018 classification. Peri‐implant diseases were also re‐defined in the 2018 classification. It is well established that both peri‐implant mucositis and peri‐implantitis are highly prevalent. In addition, peri‐implantitis is particularly challenging to manage and is accompanied by significant morbidity.Aim: To develop an S3 level CPG for the prevention and treatment of peri‐implant diseases, focusing on the implementation of interdisciplinary approaches required to prevent the development of peri‐implant diseases or their recurrence, and to treat/rehabilitate patients with dental implants following the development of peri‐implant diseases.Materials and Methods: This S3 level CPG was developed by the European Federation of Periodontology, following methodological guidance from the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation process. A rigorous and transparent process included synthesis of relevant research in 13 specifically commissioned systematic reviews, evaluation of the quality and strength of evidence, formulation of specific recommendations, and a structured consensus process involving leading experts and a broad base of stakeholders.Results: The S3 level CPG for the prevention and treatment of peri‐implant diseases culminated in the recommendation for implementation of various different interventions before, during and after implant placement/loading. Prevention of peri‐implant diseases should commence when dental implants are planned, surgically placed and prosthetically loaded. Once the implants are loaded and in function, a supportive peri‐implant care programme should be structured, including periodical assessment of peri‐implant tissue health. If peri‐implant mucositis or peri‐implantitis are detected, appropriate treatments for their management must be rendered.Conclusion: The present S3 level CPG informs clinical practice, health systems, policymakers and, indirectly, the public on the available and most effective modalities to maintain healthy peri‐implant tissues, and to manage peri‐implant diseases, according to the available evidence at the time of publication.

Dental implants have become a mainstream treatment approach in daily practice, and because of their high survival rates over time, they have become the preferred treatment option for prosthetic rehabilitation in many situations. Despite the relatively high predictability of implant therapy and high costs to patients, patient perceptions of success and patient‐reported outcome measures have become increasingly significant in implant dentistry. Increasing numbers of publications deal with oral health‐related quality of life and/or patient‐reported outcome measures. The aim of this paper was to provide an overview of the available evidence on oral health‐related quality of life of fully and partially dentate patients rehabilitated with fixed and removable implant‐supported dental prostheses. A comprehensive electronic search was performed on publications in English up to 2021. A selection of standardized questionnaires and scales used for the evaluation of oral health‐related quality of life were analyzed and explained. The analysis encompassed three aspects: a functional evaluation of oral health‐related quality of life, an esthetic assessment of oral health‐related quality of life, and a cost‐related evaluation of oral health‐related quality of life for rehabilitation with dental implants. The data demonstrated that the preoperative expectations of patients markedly affected the outcomes perceived by the patients. As expected, reconstructions supported by implants substantially improved the stability of conventional dentures and allowed improved function and patient satisfaction. However, from a patient's perspective, oral health‐related quality of life was not significantly greater for dental implants compared with conventional tooth‐supported prostheses. The connection of the implants to the prostheses with locators or balls indicated high oral health‐related quality of life. The data also suggest that patient expectation is not a good predictor of treatment outcome. In terms of esthetic outcomes, the data clearly indicate that patients’ perceptions and clinicians' assessments differed, with those of clinicians yielding higher standards. There were no significant differences found between the esthetic oral health‐related quality of life ratings for soft tissue‐level implants compared with those for bone‐level implants. Comparison of all‐ceramic and metal‐ceramic restorations showed no significant differences in patients’ perceptions in terms of esthetic outcomes. Depending on the choice of outcome measure and financial marginal value, supporting a conventional removable partial denture with implants is cost‐effective when the patient is willing to invest more to achieve a higher oral health‐related quality of life. In conclusion, the oral health‐related quality of life of patients rehabilitated with implant‐supported dental prostheses did not show overall superiority over conventional prosthetics. Clinicians' and patients' evaluations, especially of esthetic outcomes, are, in the majority of cases, incongruent. Nevertheless, patient‐reported outcomes are important in the evaluation of function, esthetics, and the cost‐effectiveness of treatment with implant‐supported dental prostheses, and should be taken into consideration in daily practice.

The aim of the present critical review is to summarize recent evidence on the prevalence of peri-implant diseases and their similarities and differences with periodontal diseases with a focus on their pathogenetic mechanisms. Reports on the extent and severity of peri-implant diseases are influenced by different case definitions. The prevalence of peri-implant diseases is reported at the subject or implant level and affected by the type of population samples analyzed (e.g., randomly selected population samples or convenience samples). The outcomes of studies on animals and humans indicate that experimental biofilm accumulation leads to a higher frequency of bleeding sites around implants as compared with teeth. Despite the proof of principle that experimentally induced mucositis may be reversible, early diagnosis and management of naturally occurring peri-implant mucositis are clinically relevant. Tissue destruction at experimental peri-implantitis sites is faster and more extensive when compared with that at experimental periodontitis sites. Although human periodontitis and peri-implantitis lesions share similarities with respect to etiology and clinical features, they represent distinct entities from a histopathologic point of view. To avoid implant loss, patients diagnosed with peri-implantitis should be treated without delay.