Peri-implant diseases are becoming a major health issue in dentistry. Despite the magnitude of this problem and the potential grave consequences, commonly acceptable treatment protocols are missing. Hence, the present paper reviews the literature treatment of peri-implantitis in order to explore their benefits and limitations. Treatment of peri-implantitis may include surgical and nonsurgical approaches, either individually or combined. Nonsurgical therapy is aimed at removing local irritants from the implants’ surface with or without surface decontamination and possibly some additional adjunctive therapies agents or devices. Systemic antibiotics may also be incorporated. Surgical therapy is aimed at removing any residual subgingival deposits and additionally reducing the peri-implant pockets depth. This can be done alone or in conjunction with either osseous respective approach or regenerative approach. Finally, if all fails, explantation might be the best alternative in order to arrest the destruction of the osseous structure around the implant, thus preserving whatever is left in this site for future reconstruction. The available literature is still lacking with large heterogeneity in the clinical response thus suggesting possible underlying predisposing conditions that are not all clear to us. Therefore, at present time treatment of peri-implantitis should be considered possible but not necessarily predictable. 1. Introduction Peri-implantitis is becoming an ever growing oral health concern that is frequently encountered in the dental office. The number of dental implants that are currently placed annually is somewhat elusive; however, the best estimate available puts this figure at around fifteen million new implants (worldwide) every year [1]. Of these, how many will eventually develop peri-implant diseases is also debatable. Zitzmann and Berglundh on behalf of the VI workshop of the European Federation of Periodontology have suggested that 80 percent of the patients and 50 percent of the implants will develop peri-implant mucositis during the years. These corresponding figures for peri-implantitis are 28–56 percent of the patients and 12–43 percent of the implants [2]. To the contrary, Mombelli et al., on behalf of the 3rd European academy of osteointegration workshop in 2012, have suggested somewhat lower numbers for peri-implantitis: 20 percent of the subjects and 10% of the implants [3]. More recently, Atieh and coworkers [4] in a meta-analysis of 504 studies which included 1497 patients with 6293 implants reported the prevalence of
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