Peri-implantitis remains one of the most challenging biological complications associated with dental implants, characterized by progressive inflammatory destruction of peri-implant tissues and subsequent bone loss. Despite significant advances in implant surface technology, regenerative procedures, and maintenance protocols, treatment outcomes remain unpredictable due to the multifactorial nature of disease progression. Traditional approaches primarily focus on the extent of bone loss and clinical parameters without adequately identifying the principal site driving disease activity.

The Peri-Implantitis–Epicenter Concept introduces a novel biological and clinical framework that identifies the primary inflammatory focus — or “epicenter”— responsible for initiating and sustaining peri-implant tissue destruction. This concept proposes that peri-implant disease progression is not uniformly distributed around an implant but is often concentrated within a localized zone characterized by microbial dysbiosis, biomechanical overload, prosthetic complications, or soft tissue deficiencies. Identification of this epicenter enables clinicians to target the true source of disease activity rather than merely addressing its secondary manifestations.

The concept integrates advanced clinical examination, radiographic assessment, prosthetic evaluation, and risk-factor analysis to establish a comprehensive diagnostic pathway. By classifying peri-implantitis according to epicenter location, biological influence, and propagation pattern, clinicians can develop individualized treatment strategies focused on elimination of the primary disease driver, enhancement of peri-implant tissue stability, and prevention of recurrence.

This lecture will present the scientific rationale behind the Epicenter Concept, its clinical applications, proposed classification system, treatment algorithms, and potential implications for future peri-implant disease management. Through clinical cases and evidence-based discussion, attendees will gain insight into a precision-oriented approach that may improve diagnostic accuracy, therapeutic predictability, and long-term implant success.