What is peri-implantitis and how to treat it?

As we have commented on many occasions, the placement of fixed teeth on dental implants has been a real revolution in the treatment of patients suffering from tooth loss. And although many patients have benefited from this treatment, it is important to know that dental implants require a series of precautions to avoid a disease called peri-implantitis which, although it is a possibility, only occurs in 15% of cases and is generally aggravated by poor hygiene practices.

What is peri-implantitis?

Peri-implantitis is a chronic infection of the gum surrounding dental implants as a result of the accumulation of bacteria in the cavity of this area. As is already known, bacteria from the oral cavity accumulate every 8 hours on the surfaces of the teeth that are connected to the implants, forming a
biofilm is known
 as bacterial plaque.

Little by little this bacterial plaque is introduced into the gum, forming a space called peri-implant pocket, where the bacteria are deposited, without the toothbrush being able to access them. All this favours the release of bacterial toxins that will destroy the bone surrounding the implant and over the years could cause the loss or failure of the dental implant.

What are the manifestations of peri-implantitis?

Contrary to what many people think, perimplantitis is usually painless. Signs and symptoms of peri-implantitis are bleeding and inflammation of the gum. However, these signs are often not perceived by the patient, as they are very subtle.

Most of the time, to detect peri-implantitis, the patient should see a dentist or dentist who will perform a probing of the gums and an x-ray. It is important to detect peri-implantitis in the early stage of the disease since the prognosis is more favourable. In the later stages, the prognosis is usually guarded.

How is peri-implantitis treated?

The treatment of peri-implantitis includes 2 phases.

Phase 1 in the treatment of peri-implantitis:

In the first phase, oral hygiene education is carried out in order to special oral hygiene techniques to increase the effectiveness of the brushing of bacterial plaque on the teeth, thus preventing bacteria from penetrating inside the gum. At this stage, deep gingival disinfection is also performed to remove bacterial deposits and antibiotics are recommended for infection control.

These treatments are only 30% effective, so in most cases, microsurgical treatment with local anaesthesia is necessary to eliminate the infection. Microsurgical treatment is minimally invasive and causes mild postoperative discomfort.

Phase 2 in the treatment of peri-implantitis: maintenance.

Once the infection has been eradicated, the patient should begin a maintenance program aimed at preventing recurrence of the disease. During implant maintenance visits, we should evaluate the condition of the gingiva by probing around the implants and taking radiographs to detect if there has been bone destruction. Afterwards, brushing instructions are reviewed and bacteria accumulated on the gum are removed by meticulous disinfection.

As we have seen, dental implants have been a great benefit for those patients with missing teeth, however, we must insist on the fact that require periodic care to avoid potentially serious diseases such as peri-implantitis. To avoid it, we must remember to have special oral hygiene and go for professional disinfection treatment with our dentist or gum specialist.

As we have commented on many occasions, the placement of fixed teeth on dental implants has been a real revolution in the treatment of patients suffering from tooth loss. And although many patients have benefited from this treatment, it is important to know that dental implants require a series of precautions to avoid a disease called peri-implantitis which, although it is a possibility, only occurs in 15% of cases and is generally aggravated by poor hygiene practices.

What is peri-implantitis?

Peri-implantitis is a chronic infection of the gum surrounding dental implants as a result of the accumulation of bacteria in the cavity of this area. As is already known, bacteria from the oral cavity accumulate every 8 hours on the surfaces of the teeth that are connected to the implants, forming a
biofilm is known
 as bacterial plaque.

Little by little this bacterial plaque is introduced into the gum, forming a space called peri-implant pocket, where the bacteria are deposited, without the toothbrush being able to access them. All this favours the release of bacterial toxins that will destroy the bone surrounding the implant and over the years could cause the loss or failure of the dental implant.

What are the manifestations of peri-implantitis?

Contrary to what many people think, perimplantitis is usually painless. Signs and symptoms of peri-implantitis are bleeding and inflammation of the gum. However, these signs are often not perceived by the patient, as they are very subtle.

Most of the time, to detect peri-implantitis, the patient should see a dentist or dentist who will perform a probing of the gums and an x-ray. It is important to detect peri-implantitis in the early stage of the disease since the prognosis is more favourable. In the later stages, the prognosis is usually guarded.

How is peri-implantitis treated?

The treatment of peri-implantitis includes 2 phases.

Phase 1 in the treatment of peri-implantitis:

In the first phase, oral hygiene education is carried out in order to special oral hygiene techniques to increase the effectiveness of the brushing of bacterial plaque on the teeth, thus preventing bacteria from penetrating inside the gum. At this stage, deep gingival disinfection is also performed to remove bacterial deposits and antibiotics are recommended for infection control.

These treatments are only 30% effective, so in most cases, microsurgical treatment with local anaesthesia is necessary to eliminate the infection. Microsurgical treatment is minimally invasive and causes mild postoperative discomfort.

Phase 2 in the treatment of peri-implantitis: maintenance.

Once the infection has been eradicated, the patient should begin a maintenance program aimed at preventing recurrence of the disease. During implant maintenance visits, we should evaluate the condition of the gingiva by probing around the implants and taking radiographs to detect if there has been bone destruction. Afterwards, brushing instructions are reviewed and bacteria accumulated on the gum are removed by meticulous disinfection.

As we have seen, dental implants have been a great benefit for those patients with missing teeth, however, we must insist on the fact that require periodic care to avoid potentially serious diseases such as peri-implantitis. To avoid it, we must remember to have special oral hygiene and go for professional disinfection treatment with our dentist or gum specialist.

Dr. Rafael Blanes
Dr. Rafael Blanes
Dental Implantology and Periodontics

Director of Clínica Pronova, trained in Barcelona, Dallas and Geneva. Meet the entire team of Clínica Pronova.

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