Prevention of initial bone remodelling around dental implants: An international clinical consensus utilising the Delphi method.

The article presents an international clinical consensus on the prevention and management of initial bone remodelling (IBR) around dental implants, developed through a three-round Delphi process involving 25 globally recognized experts in implant dentistry. While consensus was not reached on the precise definition, temporal boundaries, or prognostic significance of IBR, strong agreement was achieved on key biological and mechanical factors influencing IBR, including implant–abutment connection type, platform switching, bone envelope adequacy, insertion torque, soft tissue thickness and phenotype, abutment height, prosthetic emergence profile, and the impact of residual cement. The experts emphasized that IBR is a controllable adaptive process rather than an inevitable event, underscoring the need for standardized terminology and diagnostic criteria to improve clinical interpretation, prevention strategies, and future research on peri-implant bone stability. This consensus highlights ongoing heterogeneity in defining IBR and calls for further longitudinal studies to clarify its clinical implications.