Peri-Implantitis

Peri-implantitis is an inflammatory condition affecting the tissues around a dental implant — specifically, infection that causes progressive bone loss around the implant fixture. It is the dental equivalent of periodontitis (gum disease) around natural teeth, and is the leading cause of late implant failure.

Prevalence

Studies estimate that peri-implantitis affects approximately 20% of implants and 40% of implant patients to some degree over a 10-year period. It is more common in patients with a history of periodontitis and in smokers.

Signs and symptoms

• Bleeding around the implant when probed or when cleaning
• Swelling or redness of the gum around the implant
• Pus discharge around the implant
• Deepening of the pocket around the implant on probing
• Bone loss visible on X-ray
• In advanced cases, implant looseness (late sign)

Treatment

• Non-surgical: Professional debridement (cleaning) of the implant surface, antiseptic rinses, antibiotics. Effective for mild cases.
• Surgical: Flap surgery to access and decontaminate the implant surface. May include bone grafting to regenerate lost bone.
• Implant removal: In advanced cases where too much bone has been lost, implant removal may be the only option.

Prevention

Meticulous daily oral hygiene, no smoking, regular professional maintenance, and treatment of any residual periodontal disease are the cornerstones of prevention.