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The article reviews how research priorities evolved from early focus on titanium anchorage and osseointegration toward understanding peri-implant mucosa structure, health criteria, and wound-healing dynamics, supported by pre-clinical in vivo canine models and subsequent workshop-driven consensus 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Future  \nPeri-Implant Diseases: The Past, the Present, the Future  \nTord Berglundh   \nDepartment of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden Correspondence: Tord Berglundh ([tord.berglundh@odontologi.gu.se](tord.berglundh@odontologi.gu.se))  \nReceived: 17 September 2025 | Revised: 20 November 2025 | Accepted: 25 November 2025  \n1 | Introduction  \nPeri-implant disease is a collective term for inflammatory reactions in the tissues surrounding a dental implant. This definition was proposed in a consensus report from session IV of the 1st European Workshop on Periodontology, held in Ittingen, Switzerland in February 1993. The consensus report also identified two distinct disease entities among peri-implant diseases. Peri-implant mucositis was described as a reversible inflammatory condition in the soft tissues surrounding an implant, while peri-implantitis was characterized as inflammatory reactions with loss of supporting bone in the tissues surrounding a functioning implant. The importance of peri-implant diseases asan integrated and central part of periodontology was strengthened in subsequent European Workshops and in the 2017 World Workshop on Classification of Periodontal and Peri-implant diseases and Conditions in Chicago, organized by the European Federation of Periodontology and the American Academy of Periodontology. Although research in the field of peri-implant diseases embraces thousands of publications extending over 35 years, the time perspective in relation to periodontology overall appears short. The present review highlights milestones in clinical and experimental research on peri-implant diseases from the past to the present time. Perspectives on the future are also presented.  \nIn a historical view, it is logical to assume that the term periimplant diseases became a reality in dentistry concomitant with the introduction of dental implants. This is, however, not entirely true. In the early days of implant dentistry, the appreciation among clinicians using dental implants in restorative therapy was largely relying on the firm anchorage of the titanium device in the mandibular or maxillary bone, while less attention was paid to the soft tissue surrounding the implant. Although not proven, it was even suggested that the titanium surface of  \nthe implant exhibited protective features to the accumulation of bacteria and the formation of a biofilm. Speculations of this kind led to the assumption that the soft tissue surrounding a dental implant, that is, the peri-implant mucosa, had a lower propensity to develop inflammatory reactions than the gingiva around teeth. Results obtained from experiments performed inhuman and pre-clinical models in the early 1990s, however, opposed such theories [1–5] . Again, it is important to realize that the focus in research on peri-implant tissues at that time was mainly on the bone tissue and the osseointegration process, while studies on the peri-implant mucosa were rare. Research initiatives were therefore taken to improve the understanding of the structure and function of the peri-implant mucosa.  \n2 | Peri-Implant Tissues—The Past  \nAssessment of characteristics of healthy conditions is fundamental for the understanding and recognition of disease. Criteria need to be identified to distinguish health from disease for appraisals of prevalence of disorders and for definitions of relevant endpoints in treatment protocols [6] . Characteristics of healthy peri-implant tissues were addressed in a review by Araujo & Lindhe [7] . The review was conducted in conjunction with the 2017 World Workshop on Classification of Periodontal and Peri-implant diseases and Conditions in Chicago and provided clinical and histological characteristics for the definition of peri-implant health in a consensus report [8] . Araujo & Lindhe [7] reporte","cbCaihjqBt613XAY","https://ap.wps.com/l/cbCaihjqBt613XAY","pdf",294572,"English","# Introduction\n# Peri-Implant Tissues—The Past","[{\"question\":\"What distinguishes peri-implant mucositis from peri-implantitis?\",\"answer\":\"Peri-implant mucositis is defined as a reversible inflammatory condition in the soft tissues around an implant, whereas peri-implantitis involves inflammatory reactions with loss of supporting bone around a functioning implant.\"},{\"question\":\"How did early implant research views affect understanding of peri-implant mucosa?\",\"answer\":\"Early perspectives emphasized firm titanium anchorage and suggested that peri-implant mucosa might be less prone to inflammation, but early 1990s pre-clinical experiments opposed these theories and shifted attention toward the soft tissue.\"},{\"question\":\"Why are criteria for healthy peri-implant tissues important?\",\"answer\":\"Clear criteria are needed to distinguish health from disease for prevalence assessments and for defining relevant endpoints in treatment protocols.\"}]","Peri-Implant Diseases - The Past, the Present, the Future | PDF",1790737660]