Peri-Implantitis
Peri-implant diseases are inflammatory conditions affecting the tissue around dental implants. Like a natural tooth, bacteria can also accumulate at the base of the implant. Over time, the bacteria will irritate the gum tissue, causing inflammation, damaging the tissue, and even causing the bone to deteriorate.
Risk Factors for Peri-Implantitis
When evaluating your suitability for a dental implant, it is important to consider the risk factors for peri-implant disease. If you have previously suffered from gum disease you might be more at risk of developing peri-implant disease.
One of the biggest risk factors is poor oral hygiene and plaque buildup. This may develop if you are unable to properly clean your dental implant with a toothbrush and floss. This issue can develop from implant positioning. The implant might have been inserted to meet aesthetic concerns and functionality without considering hygiene.
Another possible risk is residual cement, where some cement is left around the implant. With a crown that is affixed with cement it can be difficult to completely remove the cement. Residual cement can cause inflammation from rough surface topography, which might then provide an environment for bacteria.
If you smoke, you are at increased risk for peri-implant disease. A study found that 78% of implants in smokers had peri-implantitis, compared to just 64% of non-smokers.
Signs and Symptoms of Peri-Implantitis
Peri-implantitis has different signs for different people. You should continue to schedule checkups every six months to monitor the condition of your implant and address any other concerns regarding your oral health.
To begin, healthy peri-implant tissue should not be swollen, bleeding, producing pus, or appear red in color.
You might notice a loosening or wobbling of the implant. This symptom is not evident at the early stage of peri-implantitis as your implant will still be fused to jawbone. It is more likely that you will notice bleeding while you brush your teeth. You might also notice swelling around the implant, bad breath, or foul taste in your mouth.
Peri-implantitis involves inflammation of the soft tissue and damage to the bone, so there is usually evidence of both bone loss with an x-ray and bleeding when the tissues are probed, which is common for soft tissue inflammation. You can experience bone loss without a sign of soft tissue inflammation.
Treatment for Peri-Implantitis
It can be challenging to treat peri-implantitis. Depending on the nature of the disease, your treatment can vary significantly, from a non-surgical treatment to control the infection and detoxify the implant surface, to a surgical approach to regenerate the bone that has been lost.
Due to the screw-shaped design of the titanium implant, mechanical debridement of the surface of the implant is ineffective in removing all bacteria. To enhance the non-surgical treatment option, mechanical debridement can be used in combination with an antiseptic, antibiotic therapy, or regenerative surgery. The combination of your treatment can vary depending on the severity of the peri-implantitis.
Cumulative interceptive supportive therapy, which is a protocol of therapeutic measures, provides guidance for your dentist to decide which approach is best to treat your peri-implantitis, depending on the condition of your soft tissue, whether there is plaque, bleeding on gentle probing, and evidence of bone loss on your x-rays.