Dental implants and peri-implantitis
What is peri-implantitis?
Peri-implantitis is an inflammatory disease marked by bacterial infection and the gradual loss of bone around a dental implant. Presently, it is unknown whether the infection causes the bone to recede, or if the bone loss exposes the area to bacteria.
What are the symptoms of peri-implantitis?
Bone loss is painless, so most people do not realise that they have the disease.
Peri-implantitis is preceded by a milder disease called peri-implant mucositis, which is common and treatable. Early warning signs are red, swollen gums and bleeding when probed. If undetected and untreated, it might become peri-implantitis. In summary:
- Not always symptomatic
- Pain severity: typically none. Possible dull aches, tenderness on brushing or touch
- Bad taste possible if pus is present
- Possible mobility (in the implant has failed)
- Lymphadenopathy (swollen lymph nodes)
How does peri-implantitis occur?
There are a number of risk factors, including:
- Poor oral hygiene / non-compliance of aftercare instructions: including hygiene treatment at home, reviews for hygiene, implant and general dentist
- Nicotine / tobacco use
- Poorly controlled systemic conditions (e.g., diabetes mellitus, osteoporosis)
- History of periodontitis and non-compliance to treatment
- Bruxism (grinding teeth)
- Poor primary implant stability and premature loading during the healing period
How is peri-implantitis diagnosed?
An X-ray will show the bone supporting the implant as receding.
Diagnosis is based on changes of colour in the gum, bleeding and probing depth of peri-implant pockets, suppuration (discharging of pus).
The cause of the implant infection is conditioned by the status of the tissue surrounding the implant, implant design, degree of roughness, external morphology, and excessive mechanical load.
How is peri-implantitis treated?
Treatment will differ depending upon whether it is a case of peri-implant mucositis or peri-implantitis. The management of implant infection should be focused on the control of infection, the detoxification of the implant surface, and regeneration of the alveolar bone.
Therefore, adjunctive peri-implant therapies, such as antibiotics, antiseptics, and ultrasonic and laser treatments, have been proposed to improve the non-surgical treatment options of peri-implant mucositis and peri-implantitis. Regenerative procedures using a bone graft substitute in combination with a membrane have been proposed to treat bone defects in advanced cases of peri-implantitis.
- Debridement – implant cleaned
- Implant surface decontamination
- Anti-infective therapy
- Surgical technique
- Implant removal
How is peri-implantitis prevented?
If you are about to embark on dental implant treatment it is important that you choose an experienced dental implant clinician who emphasises the importance of maintenance and aftercare. You implant treatment plan is not complete when your new ‘teeth’ are fitted – a focus on aftercare is vital.
After your dental implant treatment plan is complete, meticulous oral hygiene (at home and with a hygienist) and regular follow-up appointments (with your implant dentist to review your implant teeth and your general dentist to review your natural teeth) are crucial.
One of the problems with seeking treatment abroad is the absence of aftercare / maintenance / follow-up. Many of the patients that we see are patients who have sought dental implant treatment abroad.
Peri-implantitis questions/advice and referral services
- For any questions about peri-implantitis and gum disease around dental implants – from prospective patients or referring dentists – please don’t hesitate to contact us!
- For any dental implant cost questions – call to speak to a treatment coordinators
- If you are a dentist with a patient who has peri-implantitis around their implants are looking for a dentist experienced dental implant rehabilitation treatments, contact us!
- Refer to our FAQ page for more useful information