Even though dental implants are not susceptible to the decay that can cause cavities in natural teeth, patients who don’t properly care for their implants may find that they’re vulnerable to infection, gum inflammation, and possible bone loss. A condition known as peri-implantitis occurs when the implant’s soft tissue becomes inflamed by bacteria, and the infection persists long enough for the supporting bone to deteriorate. What are the symptoms to watch for, and how can you get treatment for peri-implantitis?
How Do You Know If You Have Peri-Implantitis?
There are two kinds of peri-implant diseases:
- Peri-Mucositis is identified by gum tissue inflammation but no bone loss.
- Peri-Implantitis is more serious because the bone structure below the implant shows signs of deterioration.
Until a periodontist uses radiologic imaging and gum depth probing to see if you’ve lost bone, you won’t know if you have peri-implantitis. But if your gums are red or tender surrounding the implant or you notice bleeding while brushing or flossing, you likely have a peri-implant disease.
Two researchers have proposed a classification system1 to identify the stages of peri-implantitis:
- Early peri-implantitis: A probing depth greater than or equal to 4mm, bleeding and pus formation during probing, and bone loss less than 25% of the implant length.
- Moderate peri-implantitis: A probing depth greater than or equal to 6mm, bleeding and pus formation during probing, and bone loss between 25% and 50% of the implant length.
- Severe peri-implantitis: A probing depth greater than or equal to 8 mm, bleeding and pus formation during probing, and bone loss greater than 50% of the implant length.
These classifications may help periodontists select appropriate treatment since some protocols are less successful for severe cases.
Who Is Most At Risk For Peri-Implantitis?
Peri-implant diseases occur because of the presence of plaque at the base of the implant. If you neglect to take care of the gum tissue surrounding the implant, your risk for peri-implantitis will increase. Other risk factors include:
- A history of severe gum disease (periodontitis)
- Smoking cigarettes or other tobacco users have twice the risk of developing peri-implantitis compared to non-smokers.2
- Diabetes
- Obesity
The best way to prevent peri-implant diseases is to brush and floss twice daily and schedule routine periodontal appointments to ensure that the tissue surrounding your implant is healthy. And if the infection is detected early enough, it can be treated in time to prevent bone loss.
Treatment Methods for Peri-Implantitis
Doctors and scholars have not been able to find a consensus on the best routes to treat peri-implantitis. But a few studies have concluded that some treatments are suitable for mild cases and not as effective when the disease is more severe. Here are three approaches currently used to manage peri-implantitis.
Mechanical Decontamination of the Implant Surface
Mechanical decontamination uses a variety of tools to clean the implant and affected tissue that surrounds it. These tools include:
- Periodontal curettes
- Air abrasion devices which use a low-abrasive powder to clean the surface without damaging the implant
- Ultrasonic devices
- Laser therapy
Antibiotics or Antiseptics With Mechanical Decontamination
For mild to moderate cases of peri-implantitis, using antibiotics such as amoxicillin and metronidazole or antiseptics like chlorhexidine as an adjunct to mechanical decontamination can often provide good results. However, this protocol has not proved to be effective for severe cases of peri-implantitis. 3
Surgical Treatment
Surgery is the recommended treatment method for severe cases of peri-implantitis (when bone loss is more substantial). First, the gums will be gently pulled back to remove plaque and bacteria. Then, after the area is surgically cleaned, the patient will have a bone graft procedure to regenerate the bone lost due to the infection.
Don’t Wait to Get Treatment for Peri-Implantitis.
Aside from daily brushing and flossing, the best way to ensure the long-term success of your dental implants is to visit a periodontist at the first sign of discomfort. The longer you wait to treat peri-implantitis, the greater the chance the implant will fail and require removal.
The experienced Dental Implants & Periodontal Health of Rochester team is adept at spotting the early signs of gum disease. It can intervene to reverse the effects of your peri-implant disease. Call us at 585.685.2005 or contact us online to schedule your appointment.
Sources:
[1] https://pubmed.ncbi.nlm.nih.gov/22754901/
[2] https://onlinelibrary.wiley.com/doi/10.1111/jre.12562
[3] https://www.scielo.br/j/bor/a/tKzgSDbByyVnW4bYqHQMgzG/?lang=en
