Osseointegrated dental implants are used routinely in dentistry in the confidence of predictable success. However, if the implant surfaces become colonised by pathogenic bacteria, the plaque-induced inflammation around the implants may cause peri-implant tissue destruction. Peri-implant mucositis is a reversible, plaque-induced inflammatory lesion confined to the peri-implant soft tissue unit and clinically is characterised by redness, swelling and bleeding on gentle probing. Peri-implantitis is an extension of peri-implant mucositis to involve the bone supporting the implant: it is characterised by loss of osseointegration of the coronal part of the implant, by increased probing depth and by bleeding and/or suppuration on probing. Established peri-implantitis does not respond predictably to treatment. The best management of plaque-induced peri-implant inflammatory diseases is prevention. Regular personal and professional cleaning of the implant is mandatory to minimise bacterial load. Despite our best efforts, plaque-induced peri-implant inflammatory diseases will occur frequently, and as these diseases respond best to early treatment, early detection of peri-implant mucositis by regular assessment will permit timely treatment. Peri-implant mucositis is readily treated non-surgically. Peri-implantitis is more difficult to treat largely because of the problem of decontamination of the roughened, threaded surfaces of exposed implants. As a rule, surgical treatment will be necessary, and even then success is not assured.

It is generally accepted that dental implant-treatment is "restorative" driven: the virtual blueprint of a prosthesis determines the position and number of implants to be placed. Competent interdisciplinary team-work is essential for the successful completion of implant-retained restorations. The purpose of this survey was to determine the experiences, practices and opinions in terms of the surgical placement of implants among South African prosthodontists.A questionnaire was e-mailed to a sample of South African prosthodontists. Data were collated and analysed using Epilnfo. Statistical significance was set at 0.05 and strength of association was determined by means of measurement of relative risk (RR) and chi-squared test or Fisher's exact test.The response rate was 49%. The majority of respondents were male. Mean age was 50 years and all treated patients with implant-supported prostheses. Most implants were placed by non-prosthodontists (surgeons/ periodontists) and the majority of prosthodontists reported that they were generally satisfied with implant placement by other specialities. Six prosthodontists reported that they surgically place implants themselves. Of those not placing implants, five reported that they would like to do so. Younger prosthodontists, those who had attended short courses and those who considered their "surgical training" to be adequate, were more likely to place implants themselves or to want to do so.This survey identified areas for further research into the dynamics that may cause changing habits in the management of implants in prosthodontic practices, and carries the mplication that the scope of practice of the different specialities should be continuously evaluated and adapted, to the ultimate benefit of the patient.