Abstract: Implant therapy has been developed as a routine modality for restoration of tooth missing with high predictability of treatment outcomes in a short or long run, based on rapid advancement of technology and innovation of treatment concepts. Contemporarily, restoration-driven implant placement is the fundamental principle, which has played an essential role in the progress of implant dentistry. Nonetheless, implants are artificial entities completely different from the natural teeth, especially with respect to the biological characteristics of implant-tissue interactions. The paradigm of implant treatment, thereby, should take these specific biological patterns of implant interface into consideration, not only satisfying the requirements of spatial positions of implants. This is the reason behind the necessity to propose the concept of biological-driven implant therapy. Starting from the predominant hypothesis of biofilm-induced periimplantitis, this article will comprehensively review the diversity of factors revealed that might induce or increase the risk of periimplantitis, including bacterial or non-bacterial factors, and elucidate thereafter the logical trend for the paradigm shift from restorative-driven to biological-driven implant therapy. The fundamental definition of biological-driven concept will be clarified and periimplantitis-related factors be discussed, eliciting a novel strategy for clinical prevention of periimplantitis.

Key words: Restorative-driven implant therapy, Biological-driven implant therapy, Periimplantitis, Prevention of complications