French D, et al. - Researchers assessed risk indices associated with marginal bone loss from a retrospective open cohort study of 4,591 dental implants, put in private practice, with 5- to 10-year follow-up, due to the danger of peri-implantitis. In addition, the prevalence of mucositis and peri-implantitis in the study cohort was assessed, comparing strict to relaxed criteria for bleeding on probing. To assess changes in crestal bone level, periapical radiographs were used. Significant risk indicators for bone loss have been found to include autoimmune disease, heavy smoking, bisphosphonate therapy, implant location, diameter and design, and the presence of a bone defect at the site of placement. At the implant level, the prevalence of mucositis was 38.6% vs 14.2% at 6 to 7 years, respectively, when using strict vs relaxed criteria. After 6 to 7 years, the prevalence of peri-implantitis was 4.7% and 3.6%, respectively, when using strict vs relaxed criteria. This study highlight variables that need to be considered when attempting to avoid bone loss and further recognize the broad variety of reported peri-implantitis instances and the need for universal standards.