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Implant Tribune Italian Edition - Marzo 2017 Revisione della Letteratura 23 < pagina 22 Furthermore, the clinician must use a combination of the many available clinical parameters, such as PPD, in- lammatory status of the mucosa, BOP on light probing, radiographic MBL, and possibly bacterial and/or periimplant crevicular luid biomark- ers to establish an accurate diagnosis of periimplantitis.28 Unlike in the case of periodontitis, bacterial testing may not reliable in diagnosing periimplantitis.84 This suggests that periodontal and periimplant ecosystems difer signii- cantly and, hence, periimplant dis- ease might not always be approached as an infectious disease. Similarly, such diference has been shown to apply to the pathogenesis.85 Furthermore, no evidence was found that primary infection caused mar- ginal bone resorption.86 Conclusion The available scientiic literature suggested an absence of a unani- mous deinition of periimplantitis. 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