Dental implants are one of the best solutions for replacing missing teeth in a way that is both permanent and natural-looking. However, like with any surgical procedure, dental implants carry their own risk of complications, one of which is peri-implantitis. This condition plays a huge part in the recovery process for every patient who has gotten dental implants. It involves the inflammation and infection of the tissue surrounding the implant. If left untreated, peri-implantitis could be detrimental to the success of your dental implant intervention. In this blog, we are going to cover everything you need to know about peri-implantitis, including the causes, treatment options and prevention tips.
What Causes Peri-Implantitis?
To better understand how patients can develop peri-implantitis, we must first understand how the tissues around the dental implant differ from the rest. The tissues around our teeth serve many functions, one of which being the protection of the teeth against external elements. However, the tissue surrounding a natural tooth is different from that surrounding an implant, as it doesn’t have the periodontal ligament, which is normally responsible for supporting the forces of chewing, biting, etc. The lack of this specific tissue increases the risk of microbial agents attacking the area between the bone and the implant. Most importantly, periodontal fibers can’t adhere to a dental implant in the same way they do to your natural teeth. This is the number one cause and risk factor of peri-implantitis. Nevertheless, there is a number of factors that contribute to the development of this conditions, and the list goes as follows:
- Poor oral hygiene and dental care practices;
- Predisposition to periodontitis;
- Overloading of implants, which can result due to bruxism;
- Improper positioning of the implant;
- A dental prosthetics that is poorly fitting;
- The tissues around the implant not having adequate support;
- Unstable occlusal forces;
- Substance abuse, whether alcohol or tobacco;
- Underlying health conditions such as diabetes mellitus;
- Systemic diseases which affect the immune function of the patient;
- Any kind of bacterial infections.
What Are The Most Common Symptoms Of Peri-Implantitis?
One of the most crucial aspects in dealing with peri-implantitis has to do with recognizing the symptoms of this condition as early as possible. To prevent the failure of the dental implant we must first know how to detect the first signs of implant rejection. With proper treatment, dental implant failure is evitable, therefore symptoms shouldn’t be ignored. Some of the most common signs of peri-implantitis include the following:
- Continuous swelling and inflammation of the tissue around the dental implant;
- Tenderness of the gums;
- Bleeding or pus oozing from the space separating the dental implant from the gingiva;
- Pain and discomfort when chewing, biting or putting pressure on the dental implant;
- Dental abscesses which are related to the inflammation of the gums and cheek;
- Receding gums,
- Reduction of bone mass around the dental implant;
- Bad breath.
If you notice one or more of the symptoms listed above you should contact your dentist to schedule an appointment. A thorough dental check-up is the only guaranteed way to diagnose peri-implantitis and determine the right course of treatment. If you are experiencing problems with your dental implants, book a consultation with Dr. Roland Zhuka, a leading specialist in advanced implantology. He will provide you with a comprehensive evaluation of your case and recommend the best treatment for you.
How Is Peri-Implantitis Treated?
The treatment for peri-implantitis varies from patient to patient, according to their specific conditions. The severity of peri-implantitis is also a crucial factor that should always be considered. Treatment methods include non-surgical procedures such as root planing or scaling, as well as surgical interventions such as bone grafting or flap surgery. An experienced dentist will know how to determine the most suitable treatment method for you. Below we will give a quick summary of the different types of treatments available as well as their main characteristics:
Non-Surgical Treatments
One of the most common non-surgical treatment methods for peri-implantitis is scaling and root planing. This method is quite similar to treatments for gum disease and it involves a thorough deep cleaning of the surface of the implant and the surrounding tissues, in order to remove any build-up bacterial plaque and calculus which are responsible for the development of peri-implantitis. Another treatment option involves the use of antimicrobial therapy. Your dentist may prescribe specific antibiotics or antiseptic mouthwash which will help reduce the inflammation and bacterial colonization in the affected area.
Surgical Interventions
Surgical treatment options include flap surgery and bone grafting. The chosen method depends on the patient’s exact case. During flap surgery, the dentist will lift the gum tissue to access the surface of the implant. Then, he will meticulously clean the area while removing any diseased tissue. In some cases, flap surgery can be combined with a bone grafting procedure. Bone grafting helps regenerate the lost bone support caused by peri-implantitis. The additional bone grafts are especially useful in augmenting the bone mass and volume, which in turn promotes tissue stabilization and regeneration as well as better dental implant support.
Implant Surface Decontamination
There are a few other treatments which can work well for peri-implantitis depending on the case. Laser therapy is used to decontaminate the surface of the implant and the surrounding tissues, targeting bacterial biofilm. This technique minimizes the damage done to the surrounding healthy tissues. Another option would be air abrasion, which utilizes air or gas to mechanically remove the microbial biofilm from the dental implant surface.
Guided Bone Regeneration
A more recent method used for treating peri-implantitis has to do with membrane placement. Your dentist can place a protective, barrier membrane around the site of the dental implant to prevent the ingrowth of soft tissue. This also encourages the regeneration of bone in the affected area.
Dental Implant Removal
In cases when none of the aforementioned treatments are deemed suitable and the severity of peri-implantitis has caused extensive bone loss, the removal of the implant may be the only way to prevent further complications. Once the removal process has been completed, healing ensues. Your dentist may recommend another dental implant procedure in the future.
Each of these treatment options address different symptoms and concerns related to peri-implantitis, including underlying infections, inflammation and loss of bone mass. The ultimate goal is to preserve the dental implant and support the surrounding tissues while restoring your function and oral health.
What Does The Peri-Implantitis Treatment Involve?
The choice of the treatment depends on the severity of the condition, the well-being of the patients and each patient’s individual goals. An experienced dentist will be able to determine the best course of treatment for you based on your individual needs. If you are wondering about the steps involved in the treatment of peri-implantitis, here is a simple overview of the process:
Before The Procedure
The patient is advised to discontinue smoking, maintain good oral hygiene and adhere to any prescribed medication to prepare for treatment.
During The Procedure
All treatment methods boil down to the cleaning of the surface of the implant and the surrounding tissues in order to remove bacterial deposits and promote healing.
After The Procedure
Patients are advised to follow the instructions and hygiene practices recommended by the dentist. Make sure to use the antimicrobial mouthwashes and attend follow-up appointments to monitor healing and prevent recurrence. The typical recovery time depends on the type of the treatment, the extent of the treatment and the patient’s overall health condition. Generally, it may last from a few weeks to several months.
Peri-Implantitis Treatment Post-Care
Your dentist will make sure to give you all the necessary information you need to properly take care of yourself and your dental implant after you’ve completed your peri-implantitis treatment. Be mindful to adhere to post-operative instructions, do not smoke or drink alcohol, maintain proper dental hygiene, attend regular dental appointments to minimize the risk of peri-implantitis recurrence. Here are some long-term care tips for patients who are recovering from peri-implantitis:
Maintain excellent oral hygiene. Brush your teeth three times per day and floss regularly. Try switching to a soft-bristled toothbrush and fluoride toothpaste in order to promote gum health. Flossing is crucial! If you find it hard to use dental floss, try switching to interdental brushes to clean the nooks and crevices between your teeth and around the dental implants. Rinsing with an antimicrobial mouthwash is always recommended as it helps reduce bacterial colonization.
Make sure to attend regular dental check-ups to properly monitor your healing stage. Schedule routine dental examinations and professional cleanings with your dentist. Consistent monitoring allows your dentist to detect peri-implantitis as early as possible in case of recurrence, as well as other health issues. Avoid smoking, as it increases the risk of peri-implantitis and implant failure by compromising blood flow and weakening the immune system. If you are a smoker, try to quit or avoid tobacco products at least during the healing period after your peri-implantitis treatment.
Moreover, make sure to properly manage any systemic conditions like diabetes, which can negatively impact your recovery. These conditions can increase susceptibility to infections, therefore taking care of your overall health is vital to the success of your peri-implantitis treatment. Try to maintain optimal blood sugar levels through diet, exercise and medication as prescribed by your medical provider.
Try to avoid harmful habits such as grinding your teeth or biting on hard objects. That can exert excessive force on your dental implants which can be detrimental to your peri-implantitis treatment recovery. If you have bruxism make sure to use a nightguard in order to prevent damage to implants and the surrounding tissues. Moreover, make sure to adhere to all postoperative instructions, including dental care tips and dietary restrictions. Regular follow-up appointments are recommended for proper evaluation of your recovery process.
Try to consume a nutrient-rich diet to support your overall health and immune function. Refrain from consuming alcohol as it can impair your healing stage and increase inflammation. Make sure to stay updated on proper oral hygiene techniques and dental implant care guidelines provided by dental professionals. Seek professional advice if experiencing any unusual symptoms or changes around implants.
What Happens If You Don’t Treat Peri-Implantitis?
If you choose not to undergo proper treatment for peri-implantitis, you will most likely face several consequences, both long and short term. Here are some of the potential consequences:
- Failure and potential loss of your dental implant;
- Bone loss around the dental implant site;
- Compromised oral function and esthetics;
- Sensitivity, chronic pain and discomfort;
- Risk of developing systemic health problems;
- Higher cost for future interventions due to further complication of your condition.
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