PRESS RELEASE
Landmark SEPA-led consensus identifies key surgical and prosthetic drivers of peri-implant health and disease
New consensus report highlights the critical role of surgical planning and prosthetic design in preventing peri-implant disease, warning that inadequate execution may increase the risk of peri-implantitis and calling for closer collaboration between periodontists, prosthodontists and dental technicians to improve outcomes globally
Brussels, April 28, 2026 — A previously unmet clinical need has now been addressed. The Spanish Society of Periodontology (SEPA) has led the development of a major expert consensus report providing clinical recommendations on the influence of surgical and prosthetic factors on peri
implant health and disease.
The paper, bringing together the clinical expertise of periodontists, prosthodontists and dental technicians, has been published in the Journal of Esthetic and Restorative Dentistry, under the title “Influence of surgical and prosthetic factors on peri-implant health or disease: clinical recommendations from a SEPA expert consensus”.
“This guidance document stems from the need to offer clinicians a practical framework to prevent peri-implant diseases from the outset of treatment, taking into account both surgical and prosthetic considerations,” says Dr Ignacio Sanz Sánchez, co-author of the paper.
Dr Beatriz de Tapia, co-author and SEPA board member for education and research, adds: “Implementing these recommendations may have a meaningful impact both nationally and internationally, by providing clear and consistent criteria for clinicians and dental technicians, and supporting more predictable decision-making in both clinical and laboratory settings.”
Peri-implant diseases, including peri-implantitis, remain a major concern in implant dentistry and are frequently associated with prosthesis-related factors. This review highlights the importance of integrating both surgical and prosthetic planning to reduce the risk of disease development.
Clinicians are encouraged to prioritise prosthetic designs that facilitate effective oral hygiene. Three-dimensional implant positioning — guided by the intended prosthetic outcome — is essential to minimise complications. Material selection, including ceramic and zirconia restorations, may also influence plaque accumulation.
Long-term success in implant dentistry depends on prosthetically driven planning, hygienic prosthetic design, appropriate selection of implant–abutment connections and materials, minimal implant manipulation, and maintenance tailored to patient risk.
SEPA’s leading role
SEPA has played a leading role in coordinating and driving this multidisciplinary consensus, bringing together leading expertise in periodontology, prosthodontics and dental technology, with the support of the dental company Eckermann, to translate scientific evidence into practical clinical guidance.
Key topics included three-dimensional implant positioning, implant–abutment connections, prosthetic design and component handling. This collaborative approach reflects SEPA’s ongoing commitment to promoting integrated, evidence-based dentistry and improving long-term patient outcomes.
The consensus authors include: Beatriz de Tapia, Alberto Monje, Guillermo Pradíes, Ramón Pons, Irene García, Ignacio Sanz-Martín, Ana Carrillo de Albornoz, Ferrán Puigrefagut, Iria López, Javier Pérez, Herminio García Roncero, Pep Serra, Juan Golobart, and Ignacio Sanz-Sánchez.
This multidisciplinary collaboration has resulted in practical recommendations applicable in both clinical and laboratory settings, with a clear focus on preventing peri-implant complications and improving long-term outcomes.
“None of this would have been possible without SEPA’s leadership, coordination and commitment,” highlights Dr De Tapia. “SEPA plays a key role in bringing together different disciplines and translating scientific evidence into practical guidance.” Dr Sanz Sánchez adds: “SEPA’s contribution to this initiative has been essential, reflecting its continued commitment to innovation and to addressing real-world challenges in clinical dentistry.”
Clinical recommendations
The expert consensus is structured around five key clinical domains: 1. Prosthetic design and emergence profile
- Prosthetic factors play a major role in peri-implant health.
- Designs should facilitate effective hygiene for both patient and clinician.
- Overcontouring should be avoided.
- Convex profiles are associated with increased risk of peri-implant disease. • Straight or concave profiles with an emergence angle <30° are preferred.
2. Implant positioning and surgical planning
- Implant placement should be prosthetically driven.
- Three-dimensional positioning is essential (mesio-distal, apico-coronal and bucco-palatal).
- Poor positioning may lead to unfavourable prosthetic compromises. • Guided surgery may be beneficial in complex cases.
3. Implant–abutment interface
- Internal conical connections are preferred.
- Platform switching may improve crestal bone stability.
- Polished-neck implants may benefit higher-risk patients.
4. Prosthetic components and handling
- Intermediate abutments may provide a protective effect in multiple-unit restorations.
- Narrow or concave designs are preferred.
- Abutment height >2mm may reduce early bone loss, particularly in patients with thin mucosa.
- Placement of the definitive abutment at surgery is recommended. • The “one abutment–one time” concept may reduce bone remodelling.
5. Materials, retention and maintenance
- Screw-retained restorations are preferred.
- Excess cement is a well-established risk factor for mucositis and a potential contributor to peri-implantitis.
- Zirconia shows favourable soft tissue response and lower plaque accumulation.
- No clear evidence of reduced peri-implantitis risk versus metal-ceramic restorations.
- Hygienic design, patient education and regular maintenance are essential.
SEPA – a global leader in periodontology
With more than 6,000 member periodontists and oral health professionals, SEPA is the Spanish scientific society dedicated to periodontology and implant dentistry, and is recognised as a global leader in periodontal science and clinical practice. The Society promotes high-quality clinical training, the dissemination of scientific knowledge, and research in oral health. It collaborates with academic institutions and industry partners worldwide to advance evidence-based periodontal and implant care.