***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Two systematic review s have evaluated the quality of research and reporting of observational studies investigating the prevalence of , the incidence of and the risk factors for peri-implant diseases and of experimental clinical studies evaluating the efficacy of preventive and therapeutic interventions . MATERIAL S AND METHODS For the improvement of the quality of reporting for both observational and experimental studies , the STROBE and the Modified CONSORT recommendations were encouraged . RESULTS To improve the quality of research in peri-implant diseases , the following were recommended : the use of unequivocal case definitions ; the expression of outcomes at the subject rather than the implant level ; the implementation of study validation tools ; the reporting of potential sources of bias ; and the use of appropriate statistical methods . CONCLUSIONS In observational studies , case definitions for peri-implantitis were agreed . For risk factor determination , the progressive use of cross-sectional and case-control studies ( univariate analyses ) , to prospect i ve cohorts ( multilevel modelling for confounding ) , and ultimately to intervention studies were recommended . For preventive and interventional studies of peri-implant disease management , parallel arm RCTs of at least 6-months were encouraged . For studies of non-surgical and surgical management of peri-implantitis , the use of a composite therapeutic end point was advocated . The development of st and ard control therapies was deemed essential BACKGROUND The aim of this prospect i ve study is to evaluate the prevalence of mucositis , peri-implantitis , implant success , and survival in partially edentulous patients treated for generalized aggressive periodontitis ( GAgP ) and in periodontally healthy individuals . METHODS Thirty-five patients treated for GAgP and 18 periodontally healthy patients orally rehabilitated with osseointegrated implants participated in the study . They were first examined 2 to 4 weeks before extraction of the non-retainable teeth ( baseline ) and 3 weeks after insertion of the final abutments . Additional examinations were performed during a 3-month recall schedule over a 5- to 16-year period ( mean , 8.25 years ) . At every session , clinical parameters were recorded . At 1 , 3 , 5 , 10 , and 15 years after insertion of the superstructure , a microbiological and radiographic examination was performed . RESULTS The results show implant survival rates of 100 % in periodontally healthy individuals versus 96 % in GAgP patients . The implant success rate was 33 % in GAgP patients and 50 % in periodontally healthy individuals . In GAgP patients , mucositis was present in 56 % and peri-implantitis in 26 % of the implants . In periodontally healthy individuals , 40 % of the implants showed mucositis and 10 % peri-implantitis . GAgP patients had a five times greater risk of implant failure , a three times greater risk of mucositis , and a 14 times greater risk of peri-implantitis . CONCLUSION These results suggest that patients with treated GAgP are more susceptible to mucositis and peri-implantitis , with lower implant survival and success rates Peri-implantitis is an inflammatory disease affecting soft and hard tissues surrounding dental implants . As the global number of individuals that undergo restorative therapy through dental implants increases , peri-implantitis is considered as a major and growing problem in dentistry . A r and omly selected sample of 588 patients who all had received implant-supported therapy 9 y earlier was clinical ly and radiographically examined . Prevalence of peri-implantitis was assessed and risk indicators were identified by multilevel regression analysis . Forty-five percent of all patients presented with peri-implantitis ( bleeding on probing/suppuration and bone loss > 0.5 mm ) . Moderate/severe peri-implantitis ( bleeding on probing/suppuration and bone loss > 2 mm ) was diagnosed in 14.5 % . Patients with periodontitis and with ≥4 implants , as well as implants of certain br and s and prosthetic therapy delivered by general practitioners , exhibited higher odds ratios for moderate/severe peri-implantitis . Similarly , higher odds ratios were identified for implants installed in the m and ible and with crown restoration margins positioned ≤1.5 mm from the crestal bone at baseline . It is suggested that peri-implantitis is a common condition and that several patient- and implant-related factors influence the risk for moderate/severe peri-implantitis ( Clinical Trials.gov NCT01825772 ) AIM To determine the incidence of peri-implantitis in individuals with mucositis in a 5-year follow-up study . MATERIAL AND METHODS A sample of 212 partially edentulous individuals , rehabilitated with dental implants , underwent periodontal and peri-implant clinical examinations in 2005 ( baseline ) . Five years later , 80 individuals who had been diagnosed with mucositis in the baseline examination were re-examined . These individuals were divided into two groups : one group with preventive maintenance during the study period ( GTP ; n = 39 ) , and another group without preventive maintenance ( GNTP ; n = 41 ) . The following parameters were clinical ly evaluated : plaque index , bleeding on periodontal and peri-implant probing , periodontal and peri-implant probing depth , suppuration and peri-implant bone loss . The influence of biological and behavioural risk variables associated with the occurrence of peri-implantitis was analysed using univariate and multivariate logistic regression analyses . RESULTS The incidence of peri-implantitis in the global sample was 31.2 % ( GNTP = 43.9 % and GTP = 18.0 % ) . CONCLUSION The absence of preventive maintenance in individuals with pre-existing peri-implant mucositis was associated with a high incidence of peri-implantitis . Clinical parameters , such as bleeding on peri-implant probing , periodontal probing depth and the presence of periodontitis were associated with a higher risk of developing peri-implantitis Background Due to the world-wide increase in treatments involving implant placement , the incidence of peri-implant disease is increasing . Late implant failure is the result of the inability to maintain osseointegration , whose most important cause is peri-implantitis . The aim of this study was to analyze the clinical , microbiological , and immunological aspects in the peri-implant sulcus fluid ( PISF ) of patients with healthy dental implants and patients with peri-implantitis . Methods PISF sample s were obtained from 24 peri-implantitis sites and 54 healthy peri-implant sites in this prospect i ve cross-sectional study . The clinical parameters recorded were : modified gingival index ( mGI ) , modified plaque index ( mPI ) and probing pocket depth ( PPD ) . The periodontopathogenic bacteria Tannerella forsythia , Treponema denticola and Porphyromonas gingivalis were evaluated , together with the total bacterial load ( TBL ) . PISF sample s were analyzed for the quantification of Interleukin (IL)-8 , IL-1β , IL-6 , IL-10 and Tumor Necrosis Factor (TNF)-α using flow cytometry ( FACS ) . Results The mGI and PPD scores in the peri-implantitis group were significantly higher than the healthy group ( p < 0.001 ) . A total of 61.5 % of the patients with peri-implantitis had both arches rehabilitated , compared with 22.7 % of patients with healthy peri-implant tissues ; there was no implant with peri-implantitis in cases that received m and ibular treatment exclusively ( p < 0.05 ) . Concentrations of Porphyromonas gingivalis ( p < 0.01 ) , association with bacteria Porphyromonas gingivalis and Treponema denticola ( p < 0.05 ) , as well as the TBL ( p < 0.05 ) are significantly higher in the peri-implantitis group . IL-1β ( p < 0.01 ) , IL-6 ( p < 0.01 ) , IL-10 ( p < 0.05 ) and TNF-α ( p < 0.01 ) are significantly higher at the sites with peri-implantitis compared to healthy peri-implant tissue , while IL-8 did not increase significantly . Conclusion The results of the present study involving a limited patient sample suggest that the peri-implant microbiota and which dental arch was rehabilitated involved could contribute to bone loss in peri-implantitis . A significant relationship is observed between the concentration of cytokines ( interleukins 1β , 6 and 10 and TNF-α ) and the inflammatory response in peri-implantitis tissue Purpose The aim of the present study was to retrospectively investigate the influence of potential risk indicators on the development of peri-implant disease . Methods Overall , 103 patients referred for implant treatment from 2000 to 2012 were r and omly enrolled . The study sample consisted of 421 conventional-length ( > 6 mm ) non-turned titanium implants  that were evaluated clinical ly and radiographically according to pre-established clinical and patient-related parameters by a single investigator . A non-parametric Mann-Whitney U test or Kruskal-Wallis rank test and a logistic regression model were used for the statistical analysis of the recorded data at the implant level . Results The diagnosis of peri-implant mucositis and peri-implantitis was made for 173 ( 41.1 % ) and 19 ( 4.5 % ) implants , respectively . Age ( ≥65 years ) , patient adherence ( professional hygiene recalls < 2/year ) and the presence of plaque were associated with higher peri-implant probing-depth values and bleeding-on-probing scores . The logistic regression analysis indicated that age ( P=0.001 ) , patient adherence ( P=0.03 ) , the absence of keratinized tissue ( P=0.03 ) , implants placed in pristine bone ( P=0.04 ) , and the presence of peri-implant soft-tissue recession ( P=0.000 ) were strongly associated with the event of peri-implantitis . Conclusions Within the limitations of this study , patients aged ≥65 years and non-adherent subjects were more prone to develop peri-implant disease . Therefore , early diagnosis and a systematic maintenance-care program are essential for maintaining peri-implant tissue health , especially in older patients OBJECTIVES To evaluate clinical ly and radiographically immediate implants 5 years after insertion and to compare them with delayed-placed implants in the same subjects . MATERIAL AND METHODS Twenty-two consecutive patients that needed at least two implants for replacing hopeless teeth , one immediately upon extraction and the other in a delayed fashion ( at least 4 months post- extraction ) were selected in this prospect i ve cohort study . Post- extraction immediate implants ( II ) and delayed implants ( DI ) groups were defined . One and 5 years after implant loading , clinical and radiographical outcome variables were recorded and analysed both at site and at implant level . Intra-group and inter-group comparisons were performed . RESULTS The intergroup comparison did not show significant differences for plaque index , bleeding on probing and suppuration . These parameters worsen in both groups along the study . This trend was stronger for the plaque index in the group II , which increased from 15.6 % at 1 year to 25.9 % at 5 years ( P < 0.04 ) . One year after loading , the sites with probing depth ≥5 mm were higher for the group II compared to DI ( 2.5 % vs. 0 % ; P = 0.049 ) . At the end of the study , no significant statistical differences were found . Radiographically , bone crestal changes did not yield significant differences . During the follow-up period , 25 % of the implants ( 26.4 % in group II and 23.5 % in DI ) showed biological complications : mucositis ( 20 % ) and /or periimplantitis ( 5.8 % ) . No differences between groups were found . CONCLUSIONS Within the same patients , the implants placed with the immediate protocol demonstrated a higher tendency to crestal bone loss and to peri-implantitis , although these differences were not statistically significant OBJECTIVE The objective of this prospect i ve study was to determine the prevalence and incidence of  marginal bone loss  and , in addition ,  peri-implantitis in subjects and implant sites after 10 years in function . MATERIAL AND METHODS One hundred and thirty-three subjects with a total of 407 implants that had been in function for about 5 years attended a follow-up visit in 2007 ( visit 2 ; V2 ) . 100 of the 133 subjects returned for a new clinical and radiographic examination in 2012 ( visit 3 ; V3 ) . The clinical examination included assessment of " bleeding on probing " ( BoP+ ) and " probing pocket depth . "  Subjects with implant sites that in the radiograph exhibited crater-shaped marginal bone loss of > 0.5 mm were identified as losers . RESULTS During the interval between V2 and V3 ( about 5 years ) , 13 implants in 7 subjects exhibited progressive bone loss and were removed . The overall amount of crestal bone loss that had occurred at the remaining implants between visit 1 ( V1 ; ≥1 year of loading ) and V3 ( 10 years ) was small ( 0.36 ± 1.4 mm ) . The bone-level reduction was twice as great between V2 and V3 as between V1 and V2 . Forty subjects and 75 ( 26 % ) implant sites exhibited marginal bone loss of > 0.5 mm between V1 and V3 . In the interval between V2 and V3 , 37 
    Output:
    
Currently , there is no convincing or low evidence available that identifies osteoporosis , absence of keratinized mucosa , implant surface characteristics or edentulism as risk factors for peri-implantitis .