A. Diagnosis 1 Baseline radiographic measurements following implant loading will be necessary to determine the initial position of the peri-implant bone crest Agree ✓ In disagreement I'm not sure High Consensus 98.13% 2 An additional radiograph after a loading period between 6 and 12 months should be taken to establish a bone level reference following physiological remodeling Agree ✓ In disagreement I'm not sure High Consensus 96.73% 3 Clinician must obtain baseline probing measurements at four points (M, D, MV, MP, or ML). following the completion of the implant-supported or implant-retained prosthesis Agree ✓ In disagreement I'm not sure Moderate Consensus 73.36% 4 Peri-implant tissue health and disease will be measured by means of probing Agree ✓ In disagreement I'm not sure No Consensus 63.08% 5 Bleeding on gentle probing will be a parameter for early diagnosis of peri-implant mucositis Agree ✓ In disagreement I'm not sure High Consensus 85.51% 6 The ideal periodontal probe material will be Metal Plastic Any ✓ No Consensus 56.54% 7 The ideal radiographic analysis to determine peri-implant marginal bone loss will be Periapical radiography ✓ Panoramic radiography Cone beam computed tomography Combination of systems No Consensus 58.88% 8 An early diagnosis of peri-implant mucositis will decrease the incidence of peri-implantitis Agree ✓ In disagreement I'm not sure High Consensus 97.20% B. Risk factors and risk indicators 1 Plaque/biofilm as a risk factor for peri-implant diseases will Increase ✓ Be similar Decrease High Consensus 87.38% 2 The lack of professional supportive therapy as a risk factor for peri-implant diseases will Increase ✓ Be similar Decrease High Consensus 92.52% 3 Periodontal diseases as a risk factor for peri-implant diseases will Increase ✓ Be similar Decrease High Consensus 90.19% 4 Smoking will be considered a risk factor for peri-implant diseases Agree ✓ In disagreement I'm not sure High Consensus 97.66% 5 Uncontrolled diabetes will be considered a risk factor for peri-implant diseases Agree ✓ In disagreement I'm not sure High Consensus 96.26% 6 Peri-implant keratinized mucosa deficiency (< 2 mm) will be considered a risk factor for peri-implant diseases Agree ✓ In disagreement I'm not sure High Consensus 89.25% 7 Inflammatory systemic conditions and / or diseases will be considered a risk factor for peri-implant diseases Agree ✓ In disagreement I'm not sure Moderate Consensus 72.90% C. Surgical and prosthetic considerations 1 The quality of the surgical procedure performed will influence the risk of peri-implantitis Agree ✓ In disagreement I'm not sure High Consensus 90.19% 2 Immediate implants will be more prone to peri-implant diseases Agree In disagreement ✓ I'm not sure Moderate Consensus 81.31% 3 The placement of implants in regenerated bone will be more prone to peri-implant diseases Agree In disagreement ✓ I'm not sure Moderate Consensus 80.84% 4 Regarding the location of the implant platform and its relation to bone crest, the implants will be mostly Tissue level Bone level ✓ Both of them Moderate Consensus 76.64% 5 In bone level implants, implant depth positioning will be mostly Crestal Subcrestal ✓ Both of them No Consensus 63.08% 6 Regarding the implant surface roughness, the trend will be to use Less rough implants Similar rough implants ✓ Higher rough implants Moderate Consensus 70.56% 7 Regarding the abutment surface roughness, the trend will be to use Polished abutments ✓ Textured abutments Both of them High Consensus 88.32% 8 Over-contoured restorations have the potential to retain plaque and will be associated with the development of peri-implant diseases Agree ✓ In disagreement I'm not sure High Consensus 98.12% 9 Regarding the type of prosthesis, the trend will be to use Screw retained ✓ Cement retained Screw-cement retained Any Moderate Consensus 70.56% 10 For screw-retained crowns, the type of prosthesis will be Direct to the implant fixture Screwed to an intermediate abutment ✓ Both of them No Consensus 46.73% 11 For intermediate abutments, the height of the transmucosal component will be Closer to the crestal bone Far from the crestal bone ✓ Both of them Moderate Consensus 84.11% D. Prevalence 1 The prevalence of peri-implant mucositis will be Higher ✓ Less Similar No Consensus 64.02% 2 The prevalence of peri-implantitis will be Higher ✓ Less Similar No Consensus 64.02% 3 The prevalence of peri-implant soft tissue deficiencies will be Higher ✓ Less Similar No Consensus 47.20% E. Treatment of peri-implant mucositis 1 The treatment of mucositis will be carried out mainly by General Dentist Specialist ✓ Hygienist Anyone Moderate Consensus 78.04% 2 The treatment of mucositis will be mainly focused on Mechanical debridement Antimicrobials Both of them ✓ Moderate Consensus 72.90% 3 Mechanical debridement will be carried out mainly with Curettes Ultrasounds Air polishing systems Combination of systems ✓ High Consensus 93.93% 4 Pharmacological treatment will be carried out mainly with Antiseptics Antibiotics Both of them ✓ Moderate Consensus 70.09% 5 The ideal curettes material will be Surgical steel Titanium Plastic Any ✓ No Consensus 37.38% 6 Laser decontamination will be needed to treat mucositis Agree In disagreement ✓ I'm not sure No Consensus 43.46% F. Treatment of peri-implantitis 1 The treatment of peri-implantitis will be carried out mainly by General Dentist Specialist ✓ Both of them High Consensus 98.13% 2 The treatment of peri-implantitis will be mainly Surgical Non-surgical Both of them ✓ Moderate Consensus 74.30% 3 Surgical treatment of peri-implantitis will be mainly Resective Regenerative Both of them ✓ Moderate Consensus 84.11% 4 A non-surgical phase before surgery will be necessary Agree ✓ In disagreement I'm not sure High Consensus 93.46% 5 The choice of the treatment approach will depend on the peri-implant defect morphology Agree ✓ In disagreement I'm not sure High Consensus 99.07% 6 Decontamination of the exposed implant surface will be mainly Mechanical Chemical Both of them ✓ High Consensus 95.33% 7 Mechanical decontamination of the exposed implant surface will be mainly done with Curettes Ultrasounds Air polishing systems Laser Rotary systems Combination of systems ✓ High Consensus 97.20% 8 Chemical decontamination of the exposed implant surface will be mainly done with Chlorhexidine ✓ Hydrogen peroxide Local antibiotic EDTA Other No Consensus 62.15% 9 In reconstructive approaches a bone substitute will be necessary to fill the defect Agree ✓ In disagreement I'm not sure High Consensus 95.33% 10 The standard bone replacement graft will be Allogenic Autologous Xenograft ✓ Alloplastic Moderate Consensus 74.77% 11 In reconstructive approaches the use of a membrane will be necessary Agree ✓ In disagreement I'm not sure High Consensus 92.99% 12 The implantoplasty will be part of the resective therapy Agree ✓ In disagreement I'm not sure High Consensus 85.98% 13 Surgical approaches applying growth factors will favor re-osseointegration in the future Agree ✓ In disagreement I'm not sure No Consensus 59.35% 14 Anti-inflammatory agents will be helpful in counteracting peri-implantitis Agree In disagreement ✓ I'm not sure No Consensus 50.00% G. Diagnosis and treatment of peri-implant conditions and deficiencies 1 Mucosal thickness will be an important factor for the esthetics outcome and for the prevention of mucosal recession Agree ✓ In disagreement I'm not sure High Consensus 99.07% 2 Mucosal thickness will be an important factor for peri-implant health Agree ✓ In disagreement I'm not sure High Consensus 96.73% 3 The correct diagnosis of peri-implant soft tissue dehiscence/deficiencies at single implant site will require the assessment of The bucco-lingual position of the implant crown/platform only The height of the peri-implant papilla only Both the bucco-lingual position of the implant and the papillae height ✓ Moderate Consensus 76.64% 4 The trend for treating peri-implant soft tissue dehiscence/deficiencies will involve the use of Allografts Autologous grafts ✓ Xenografts Moderate Consensus 84.58% 5 The implant-supported crown should be always removed at least one month before the treatment of peri-implant soft tissue dehiscence/deficiencies, with a new definitive crown fabricated 6-9 months after the surgery Agree In disagreement It depends on the length of the crown, adjacent and homologous teeth and patient's expectation ✓ Moderate Consensus 72.90% 6 The reconstruction of the interproximal papilla between an implant with soft tissue dehiscence and the adjacent teeth will be predictable Agree In disagreement ✓ I'm not sure Moderate Consensus 73.36% H. Prevention and maintenance 1 Maintenance will be carried out mainly by General Dentist Specialist ✓ Hygienist Anyone Moderate Consensus 74.77% 2 Individualized oral hygiene instructions should be given based on the ability of each patient Agree ✓ In disagreement I'm not sure High Consensus 99.53% 3 In patients with local risk factors, the frequency of maintenance appointments will be every 3 months ✓ 4 months 6 months Moderate Consensus 84.11% 4 In patients with systemic risk factors, the frequency of maintenance appointments should be every 3 months ✓ 4 months 6 months Moderate Consensus 78.97% 5 In patients with periodontitis, it will be contraindicated to place dental implants before a successful periodontal treatment Agree ✓ In disagreement I'm not sure High Consensus 94.86% 6 Improving the height of attached keratinized mucosa will be an alternative to prevent peri-implant diseases Agree ✓ In disagreement I'm not sure High Consensus 92.99% 7 When fixed implant-supported restorations impede proper diagnosis or oral hygiene access, the restoration must be removed or recontoured Agree ✓ In disagreement I'm not sure High Consensus 98.60% 8 Prevention of peri-implant diseases will be reached by means of Anti-inflammatory agents Hygiene and patient behavior ✓ Antimicrobial therapies High Consensus 100% 9 Preventive strategies will be efficient to control peri-implant diseases Agree ✓ In disagreement I'm not sure High Consensus 97.20%