Implantology — Complications
What stage of peri-implant disease is this, and what's the correct CIST protocol response?
Case
On a 6-month review, an implant shows bleeding on probing but the periapical radiograph shows no measurable bone loss compared to baseline.
Peri-implantitis Stage C — systemic antibiotics required
Correct —Peri-implant mucositis — mechanical debridement and oral hygiene instruction
Peri-implantitis Stage D — surgical intervention required
No action needed until bone loss appears on radiograph
Explanation
Bleeding on probing with no bone loss on radiograph is peri-implant mucositis — the reversible precursor to peri-implantitis. CIST Stage A treatment (mechanical debridement + oral hygiene instruction) is correct here, and this is a critical window: mucositis resolves with treatment, established bone loss does not reverse.
Clinical Pearl
Never wait for bone loss to show on radiograph before treating — by then you're already at Stage C. Bleeding on probing alone is your trigger to act.
Reference: CIST Protocol