Peri-implant diseases are inflammatory conditions affecting the soft and hard gum tissues around dental implants.

Similar to a natural tooth, bacteria can build up on the base of the implant, below the gum line. Over time, the bacteria irritate the gum tissue, causing it to become inflamed, damaging the tissue, and if not caught early, causing the bone structure below the implant to deteriorate.

Categories

Peri-implant diseases are classified into two categories.

In peri-implant mucositis, gum inflammation is found only around the soft tissues of the dental implant, with no signs of bone loss.

Generally, peri-implant mucositis is a precursor to peri-implantitis. Evidence suggests that peri-implant mucositis may be successfully treated and is reversible if caught early.

In peri-implantitis, gum inflammation is found around the soft tissue and there is deterioration in the bone supporting the dental implant. Peri-implantitis usually requires surgical treatment.

Signs of implant diseases

Signs of peri-implant diseases are similar to symptoms of gum disease: red or tender gums around the implants, or bleeding when brushing. And just like your natural teeth, implants require regular tooth brushing and flossing, and regular check-ups from a dental professional.

It is essential to routinely monitor dental implants as part of a comprehensive periodontal evaluation. The following are key early signs and symptoms of peri-implantitis to look out for:

• A bony defect with a crater-like shape;

• Redness and swelling of the soft tissue;

• Bad taste possible if pus is present;

• Bleeding on probing or brushing;

• Swollen lymph nodes; and

• Dull aching or tenderness of gums.

Causes of peri-implantitis

Patients who have implants are at risk of developing peri-implantitis. Peri-implantitis is caused by the gum surrounding a tooth implant becoming inflected. Peri-implantitis causes and risk factors include:

• Poor oral hygiene;

• Tobacco use;

• Poorly controlled systemic conditions (for example, diabetes mellitus, osteoporosis);

• History of periodontitis and non-compliance to treatment;

• Bruxism (grinding teeth) and other parafunctional habits; and

• Poor primary implant stability and premature loading during the healing period.

Treatments for peri-implantitis

The management of peri-implantitis should be focused on the control of the infection, the detoxification of the implant surface, and regeneration of the alveolar bone.

While surgery is usually required for treatment of peri-implantitis, some patients prefer to opt for non-surgical treatment options.

Non-surgical peri-implant therapies include:

• Antibiotics;

• Antiseptics;

• Ultrasonic; and

• Laser treatments.

Regenerative procedures using a bone graft substitute in combination with a membrane have also been proposed to treat bone defects in advanced cases of peri-implantitis. This procedure involves the following:

• Debridement – implant cleaned;

• Implant surface decontamination;

• Anti-infective therapy; and

• Implant removal.

The upside to dental implants is they function just like your natural teeth. The down side is that they are capable of becoming diseased, just like natural teeth. With a proper oral health routine, your dental implants can last a lifetime.

Dr Sharon Robinson, DDS has offices at Dental Place Cosmetix Spa, located at shop #5, Winchester Business Centre, 15 Hope Road, Kingston 10. Dr Robinson is an adjunct lecturer at the University of Technology, Jamaica, School of Oral Health Sciences. She may be contacted at 876-630-4710. Like their Facebook page, Dental Place Cosmetix Spa.