Peri Implantitis: Understanding The Hidden Threat In Dental Implant

Dental
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As the use of dental implants to replace missing teeth is becoming popular, the incidence of peri implantitis is also increasing.

Peri implantitis is a severe inflammation affecting the supporting soft and hard tissue of the implant that eventually leads to implant mobility and eventually implant failure*.Peri implantitis affects the implant supporting tissue in a similar way like how periodontitis affect natural tooth supporting structure*

Bacterial biofilm that accumulated around the implant is the primary cause of peri implantitis. Lack of good oral hygiene is the main reason for this bacterial biofilm accumulation around the implant.

Other risk factors are are:

  • Smoking

  • Uncontrolled diabetes mellitus

  • Pre existing periodontal diseases

  • Improper placement of implant

  • Excessive bite force on the implant due to premature loading of the implant

Signs and Symptoms

  • Bleeding on probing

  • Increased probing depth

  • Peri implant mucosal recession from the base line record

  • Redness

  • Swelling and suppuration from the infected site

  • Radiographs show marginal bone loss

Management

The management can be divided as :

  • Non surgical therapy

    • Scaling and root planning: debridement of the implant surface using specialised carbon, plastic or titanium curettes.

    • Antibiotic: Application of either systemic or local antibiotics

    • Laser therapy: Er : YAG laser is used to decontaminate implant pockets

  • Surgical therapy

    • Flap surgery: It is usually performed when the implant surface is inaccessible for debridement.

    • Guided Tissue Regeneration: when there is vertical bone defect around the implant bone grafting is attempted to regain lost bone

    • Respective surgery : trims the inflamed soft tissue and planning is done on the implant surface.

When the implant has severe bone loss and excessive supportive tissue loss the only option left is to remove the implant.

Prevention

Peri implantitis is a preventable condition, and the key to it is good oral hygiene. In cases of patients with other systemic conditions, getting those under control automatically protects your implant.

Increasing the awareness about peri implantitis is the only way for early detection, diagnosis and better treatment outcomes in these cases

MBH/DB

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Very well said!

Peri-implantitis should be taken of priorly as well. As a patient with poor oral health will eventually go through this condition, so it depends more upon the patient how they are taking care post procedure.

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True! Peri-implantitis can be prevented or its risk reduced with good oral hygiene. For patients with accompanying systemic conditions, regular nudges from the implantologist to keep the condition under control could also play an important role in maintaining long-term implant health.