Naples Periodontics and Implant Dentistry
The Problems With Peri-Implantitis and Dental Implants
Dr. Denise C. Gay
Dental implants are commonly used as an effective treatment to replace missing or diseased teeth. The placement of dental implants by an experienced, board-certified periodontist or oral surgeon can provide patients many years of satisfaction, as implants look, feel, and function much like natural teeth.
What is perhaps not commonly known among patients is that dental implants are subject to the same disease processes and risk factors as natural teeth. For example, people that have a predisposition for periodontal disease are also more likely to experience dental implant complications. Other risk factors include smoking, diabetes, osteoporosis, patients undergoing radiation therapy, and improper implant placement. In the case of oral disease, the primary antagonist of natural teeth and dental implants are bacteria that persistently attempt to invade supporting structures of both. In each case, bacterial infection results in tissue inflammation and can eventually lead to bone loss. This condition can eventually cause tooth loss or implant failure. In the case of natural teeth, this advanced condition is called periodontitis. With respect to dental implants, it is called peri-implantitis.
Diagnosis of Peri-Implantitis
Peri-implantitis is commonly diagnosed through presentations that include the following:
• Radiological evidence of bone loss
• Formation of a deeper implant pocked
• Bleeding and puss evident while probing around the implant
• Swelling of tissues surrounding the implant
• Movement of the implant, which would result in the removal of the implant
The treatment of peri-implantitis, both surgical and non-surgical, centers on removing bacteria, infected tissue, and the regeneration of the bone loss when indicated. Where there is no bone loss, treatment of peri-implantitis will commonly center on the removal of plaque and calcium (hardened tartar) through mechanical and ultrasonic debridement and hygiene intervention, both in the office and at home.
Advanced peri-implantitis that includes bone loss can be treated through surgical debridement and bone grafting to regenerate the critical supporting areas around the implant.
In cases where a dental implant must be removed, treatment focuses on restoring the patient's oral health while regenerating the bone defect in the jaw left after implant removal. This is accomplished through bone grating.
Prevention is Key
An ongoing periodontal maintenance program is the key to preventing peri-implantitis. Regular doctor visits along with routine periodontal hygiene treatments multiple times per year serve as monitors for the signs of bacterial infection and inflammation that can lead to peri-implantitis. Early detection and treatment of peri-implantitis will increase the longevity and health of dental implants.
There is no boilerplate treatment modality for peri-implantitis. The experience level of the individual practitioner is a crucial factor for the success of dental implants and also with the treatment of complications that can occur after dental implants are placed.
Please contact my office for any concerns regarding your dental implants and any questions regarding your overall oral health.