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Journal of Oral Science & Rehabilitation Volume 2 | Issue 4/2016 49 D e f i n i t i o n o f p e r i i m p l a n t i t i s qvist et al. included cases of PPD > 5 mm and MBL ≥ 3 mm.62 Two other studies, one prospec- tive63 and one retrospective,64 applied the pres- ence of BOPand/or SUP, PPD > 5 mm and radio- graphic signs of MBL, without specifying the baseline bone level. Positive BOP and/or SUP, radiographic MBL≥ 3 mm and PPD ≥ 6 mmwere used by Koldsland et al.47 Atthe7th and8th EuropeanWorkshoponPeri- odontology,periimplantmucositisandperiimplan- titis were described as follows: “changes in the levelofcrestalbone, presence ofbleeding on pro- bing and/or suppuration; with or without conco- mitant deepening of peri-implant pockets.”6, 8 Periimplant mucositis was defined with positive BOPand/orSUPand periimplantitiswith positive BOPand/orSUP,incombinationwithradiographic MBL≥2mm.Thesameparameterswereusedby Zitzmann and Berglundh to define periimplanti- tis.65 However, Atieh et al. used the same criteria, plus PPD ≥ 5 mm, asthe definition ofperiimplan- titis in their systematic review paper.4 Discussion Periimplant diseases present in two forms: periimplant mucositis and periimplantitis.10 Both are characterized byan inflammatoryreaction in the tissue surrounding an implant. Periimplant mucositis has been defined as a reversible in- flammatoryreaction inthe soft-tissue surround- ing an implant in function, whereas periimplan- titis has been defined as a more profound inflammatorylesioncharacterizedbyadeepened periimplant pocket and loss of supporting bone around a functional implant.10, 24 Studies published in early 2010 suggested that mucositis and periimplantitis are equivalent to periodontitis, since both are described as an imbalance between bacterial load and the host response.8, 25 Based upon this, both diseases are closely related to the formation of a biofilm con- taining microbiota rich in Gram-negative bacte- ria in the presence of a susceptible host.66 How- ever,ithasbeenshownthatmicroorganismsmay Radiographic marginal bone loss Fig. 3 Percentage of the included studies relating to different radiographic MBL values used to define periimplantitis. > 3–4 mm 35% > 5 mm 5% > 0.5–1 mm 15% > 1–2 mm 45% Fig. 3 Volume 2 | Issue 4/201649