Ultima modifica 20 May 2023
Peri-Implantitis: Understanding, Preventing, and Treating
What is Peri-Implantitis?
Peri-implantitis is an inflammatory disease affecting the tissues surrounding a dental implant. Similar to periodontitis, this disease can lead to the loss of the implant’s supporting bone and, if not properly treated, can cause the loss of the implant itself.
While peri-implant mucositis, another common condition, only affects the soft tissues around the implant, peri-implantitis also extends to the bone level. The distinction is crucial because, while mucositis can be reversed with proper treatment, the bone loss caused by peri-implantitis is, in most cases, irreversible.
Symptoms
Peri-implantitis can present with various symptoms, depending on the severity of inflammation and bone loss.
Here are the most common ones:
Pain: One of the first perceivable symptoms of peri-implantitis can be discomfort or pain around the implant. This pain can be constant or may only appear when pressing the implant or eating.
Swelling and redness: The tissues surrounding the implant may swell and become red due to inflammation. This can be accompanied by an increase in local temperature.
Bleeding: Similar to periodontitis, peri-implantitis can cause bleeding when brushing your teeth or using dental floss. This bleeding can be a sign of inflammation.
Suppuration: In some people, pus discharge may occur around the implant. This is a clear sign of infection.
Implant mobility: As peri-implantitis progresses and the surrounding bone is lost, the implant may start to move or even fall out. This is usually a sign of advanced peri-implantitis.
If you notice any of these symptoms, it’s advisable to immediately consult a dentist who specializes in implantology.
Causes
Peri-implantitis is usually the result of bacterial plaque accumulation around the implant. However, there are various factors that can increase the risk of developing the disease:
Lack of oral hygiene: Adequate oral hygiene is critical to prevent plaque build-up. If plaque is not removed, it can cause inflammation and, eventually, peri-implantitis.
Smoking: Cigarette smoking is one of the most significant risk factors for peri-implantitis. Smoking can compromise the immune system, making it harder for the body to fight infections. Furthermore, smoking can reduce blood flow to the mouth, slowing down the healing process and increasing the risk of post-operative complications.
History of periodontitis: Those who have already suffered from periodontitis are at a higher risk of developing peri-implantitis. This is because periodontitis and peri-implantitis are both caused by bacterial plaque and can progress in a similar way.
Diabetes: Diabetes, especially when poorly managed, can increase the risk of infections, including peri-implantitis. Diabetes can also slow down the healing process, making recovery from dental procedures like implant placement more challenging.
Immunosuppression: People with a weakened immune system, for example due to diseases like HIV or cancer therapies such as chemotherapy, may have a higher risk of developing peri-implantitis.
Diagnosis
The diagnosis is made based on the patient’s symptoms, clinical examination, and the results of imaging tests such as panoramic radiography or cone beam computed tomography (three-dimensional radiography). During the clinical examination, the dentist can check for plaque, soft tissue inflammation, bleeding and/or suppuration, and can also verify whether the implant is stable or mobile.
The radiographic examination can reveal bone loss around the implant. A healthy implant should be surrounded by bone on all sides.
Treatment
Peri-implantitis treatment focuses on two main goals: controlling the infection and stopping the progression of bone loss. The treatment may include:
Home oral hygiene: The first step in treating peri-implantitis is improving oral hygiene. This may include instruction on brushing and flossing techniques, the use of antimicrobial mouth rinses, and, in some cases, the use of antibiotics.
Professional oral hygiene: In many cases, one or more sessions of professional oral hygiene of the implant will be necessary. This may include debridement (removal of infected tissues) and removal of plaque and tartar.
Antimicrobial therapy: Antibiotics can be used to help control the infection. These can be administered systemically (for example, in pills) or locally (applied directly to the infected area).
Regenerative surgery: In some cases, a surgical procedure may be needed to remove infected tissue and attempt to regenerate lost bone. This may include techniques such as grafting artificial or homologous bone and the use of membranes to promote bone regeneration.
Implant removal: In severe cases, where peri-implantitis cannot be controlled and the implant is no longer stable, it may be necessary to remove the implant.
It is important to note that the treatment of peri-implantitis should be personalized for each patient, depending on the severity of the disease, the patient’s overall health, and other factors.
Preventing Peri-implantitis
Prevention is key to managing peri-implantitis:
Maintain good oral hygiene: This is the most important step you can take to prevent peri-implantitis. Be sure to brush your teeth at least twice a day, floss daily, and have regular check-ups with your dentist.
Quit smoking: If you’re a smoker, doing all you can to quit can make a big difference in reducing your risk of peri-implantitis.
Manage your overall health: If you have diabetes or other conditions that can increase the risk of infections, make sure these are well controlled. This may include taking your medications regularly, maintaining a healthy diet, and getting sufficient physical exercise.
Regular dental visits: Regular check-ups with your dentist can help to identify early signs of peri-implantitis. The dentist can also prescribe a personalized schedule for professional oral hygiene sessions for plaque and tartar that brushing and flossing might not be able to remove.
Peri-implantitis is a serious condition that can lead to the loss of the dental implant if not adequately treated. However, with good oral hygiene, regular visits to the dentist, and proper management of health conditions, it is possible to significantly reduce the risk of developing this disease.
Remember, prevention is always better than cure. So, take care of your dental implants in the same way you would take care of your natural teeth.
If you have any questions or concerns, don’t hesitate to contact your dentist or Grimaldi Dental Center.
Frequently Asked Questions
What is peri-implantitis?
Peri-implantitis is an inflammatory disease that affects the tissues around a dental implant, leading to the loss of the implant’s supporting bone. If not adequately treated, it can cause the loss of the implant.
What problems can a dental implant cause?
If not properly cared for, a dental implant can lead to various problems, including infection of the surrounding tissues (peri-implantitis), pain, swelling, bleeding, and in more severe cases, the loss of the implant itself.
Who treats peri-implantitis?
Peri-implantitis is treated by a dentist or a periodontist, specialists in diagnosing and treating diseases of the oral tissues, including bone and gums.
Can someone with periodontitis get animplant?
Someone with periodontitis can get a dental implant, but it is essential to manage the periodontitis first. Periodontitis is a serious gum infection that damages the soft tissue and destroys the bone supporting the teeth, which can lead to tooth loss. If periodontitis is not adequately treated before the placement of an implant, it can increase the risk of peri-implantitis, a similar infection around the implant.
Therefore, before considering a dental implant, it is necessary to treat the periodontitis and ensure that it is well controlled. This includes improving oral hygiene practices, having regular dental check-ups, and possibly undergoing a specific periodontal treatment. After periodontitis has been effectively managed, a dental implant can be considered.
Moreover, the patient must maintain excellent oral hygiene and regular dental visits even after the implant has been placed to minimize the risk of peri-implantitis.
Can peri-implantitis be cured?
Peri-implantitis can be effectively managed with the right treatment, and further bone loss can be halted. However, it requires a commitment to excellent oral hygiene practices and regular dental visits. In some cases, surgical intervention may be needed, including procedures to clean the implant surface and promote bone regeneration. If peri-implantitis is detected early and treated effectively, it is possible to save the implant.
What are the signs of peri-implantitis?
The signs of peri-implantitis may include redness and swelling of the gums around the implant, bleeding when brushing, pus coming from the gums, a bad taste in the mouth, and in later stages, possible loosening of the implant and discomfort or pain. If you notice any of these signs, it is important to seek dental advice as soon as possible.
Keep in mind that sometimes peri-implantitis can progress without noticeable symptoms, so regular dental check-ups are critical to detect any potential problems early.
If you have further questions or need assistance, please feel free to reach out to us at Grimaldi Dental Center. Our team is always ready to help
