Pocket probing depth (PPD) and bleeding on probing (BOP) measurements are useful indices for the assessment of periodontal conditions. The same periodontal indices are commonly recommended to evaluate the dental implant/tissue interface to identify sites with mucositis and peri-implantitis, which, if not treated, are anticipated to lead to implant failure. The aim of the present narrative review is to discuss the available literature on the effectiveness of probing at dental implants for identification of peri-implant pathology. There is substantial clinical evidence that PPD and BOP measurements are very poor indices of peri-implant tissue conditions and are questionable surrogate endpoints for implant failure. On the contrary, the literature suggests that frequent disturbance of the soft tissue barrier at implants may instead induce inflammation and bone resorption. Moreover, over-diagnosis and subsequent unnecessary treatment may lead to iatrogenic damage to the implant-tissue interface. Despite this, the recommendations from recent consensus meetings are still promoting the use of probing at dental implants. For evaluation of implants, for instance at annual check-ups, the present authors recommend a clinical examination that includes (i) a visual inspection of the peri-implant tissues for the assessment of oral hygiene and the detection of potential redness, swelling, (ii) palpation of the peri-implant tissues for assessment of the potential presence of swelling, bleeding, suppuration. In addition, (iii) radiography is recommended for the assessment of crestal bone level for comparison with previous radiographs to evaluate potential progressive bone loss even if there is a need for more scientific evidence of the true value of the first two clinical testing modes.

Background: Peri‐implantitis has been suggested to cause significant increasing proportions of implant failure with increasing time.Purpose: To assess whether implant failure rates in long term studies are matching the supposed high prevalence of peri‐implantitis.Material and Methods: This paper is written as a narrative review of the long‐term clinical investigations available in the literature.Results: Some implant systems have seen unacceptable marginal bone loss figures with time coupled to increased implant failure rates, resulting in the withdrawal of these systems. The reasons for such mishap are generally unknown, with the exception of one system failure that was found to be due to improper clinical handling. Modern, moderately rough implant systems have functioned excellently over 10–15 years of follow up with minor problems with marginal bone loss and implant failure rates within a few per cent. Machined implants have functioned adequately over 20–30 years of follow up. Implant failures occur predominantly during the first few years after implant placement. No significant increase of implant failures has been observed thereafter over 20–30 years of follow up.Over the years of our new millennium, scientific and technical advances have allowed the discovery of numerous molecular pathways and cellular interactions between the skeletal and immune system promoting the development of the interdisciplinary field called osteoimmunology. Nowadays, this knowledge has not only allowed the emergence of new etiologic paradigms for bone disease but also a new dynamic approach on the concept of osseointegration and MBL around oral implants, re‐evaluating our older disease oriented outlook. This facilitates at the same time the emergence of translational applications with immunological perspectives, scientific approaches based on omics sciences, and the beginning of an era of personalized dental implant therapy to improve the prognosis of oral implant treatment.Conclusions: Oral implant systems have been found to function with very good clinical outcome over follow‐up times of 20–30 years. Registered implant failures have occurred predominantly during the first few years after implantation, and there has been no significant increase in late failures due to peri‐implantitis.