Peri-implant diseases are a frequent challenge in daily clinical practice. Since the predictability and long-term stability of their treatment are still under debate, prevention should remain the cornerstone of our therapeutic approach. In this context, prevention must begin even before implant placement, through careful control of patient-related risk factors and a comprehensive treatment planning strategy.

For this reason, surgical and prosthetic decision-making plays a key role in what we could call a “primordial prevention” approach to peri-implant diseases. Every step matters: from flap design and tissue management to the selection of the surgical approach and implant characteristics. Equally important is a prosthetically driven implant placement that allows for an adequate three dimensional position of the implant and, consequently, a restoration design that facilitates hygiene access and long-term maintenance.

In addition, aspects such as prosthetic emergence profile, prosthesis design, and the fit and seating of the restoration may significantly influence peri-implant tissue stability over time. This session will discuss how many of the biological complications we face today may actually originate from decisions made long before peri-implantitis develops.