Dental Practitioners' Knowledge and Attitudes Toward the Etiology, Diagnosis, and Treatment of Peri-Implantitis

Objectives: The objective of this study was to assess the level of knowledge and attitude about the etiology, diagnosis, and management of peri-implantitis among dental practitioners. Methods: An online cross-sectional study on 303 dentists in Saudi Arabia was conducted. A closed-ended survey consisting of 28 questions was designed. Three sections were created, i.e., (1) participants' characteristics; (2) knowledge of peri-implantitis etiology, risk factors, diagnosis, and complications; and (3) the use of antibiotics to manage peri-implantitis and methods used for diagnosis and treatment. The data were analyzed using mean and percentages. Results: A total of 303 dentists participated in this study with a 78.8% response rate, comprising 80% general dentists and 20% specialists. The majority of dentists demonstrated knowledge about peri-implantitis, with 85.5% identifying bacterial plaque as an etiologic factor and 83.8% recognizing it as an inflammatory reaction. Regarding risk factors, 88.1% identified smoking and 86.1% recognized periodontitis as contributors to peri-implant disease development. In terms of clinical decision making, 63% of participants considered implant mobility as a definitive indication for implant removal, and more than half reported using crater-like bone defects surrounding implants as a diagnostic criterion for peri-implantitis. For antimicrobial therapy, amoxicillin alone (30%) was the most commonly prescribed antibiotic, followed by the combination of amoxicillin with metronidazole (29%). Despite these treatment approaches, it is important to note that currently there are no established, predictable protocols for treating any phase of peri-implant disease. Conclusion: While participating dentists demonstrated a strong understanding of peri-implantitis etiology and risk factors, particularly regarding bacterial plaque and smoking as major contributors, there was considerable variation in antibiotic selection and usage patterns. These findings suggest the need for standardized guidelines and further research to establish evidence-based protocols for managing peri-implant diseases.