Which finding during peri-implant maintenance would most urgently prompt intervention?

• A. Mild bleeding on probing without mobility.
• B. Moderate probing depths with bleeding and suppuration.
• C. No movement and stable radiographs.
• D. Asymptomatic radiographic changes.

Answer: (B)

In peri-implant maintenance, the most urgent indication for intervention is when there are moderate probing depths accompanied by bleeding and suppuration around the implant. This combination points to active infection with tissue breakdown around the implant, i.e., peri-implantitis, rather than just harmless inflammation. Bleeding signals inflammatory changes, and suppuration indicates purulent infection, both suggesting that the supporting tissues are deteriorating and bone loss may be progressing. Because this situation can escalate quickly, it warrants prompt clinical assessment, targeted cleaning to decontaminate the implant surface, possible antimicrobial therapy, and a plan to address the defect—sometimes calling for surgical access to manage osseous pockets and halt progression.

Mild bleeding on probing without mobility often reflects mucositis, an inflammatory condition confined to the soft tissues, and it’s typically managed with meticulous plaque control and reinforcement of maintenance visits. No movement with stable radiographs indicates good implant stability and no radiographic evidence of progression, which is reassuring and usually followed with routine maintenance. Asymptomatic radiographic changes can be ambiguous and may reflect remodeling or historical bone loss, but without clinical signs of active infection or deterioration, they do not usually demand urgent intervention.