Management of Peri-Implant Infections

It’s crucial to recognize that peri-implant diseases progress swiftly and can cause rapid damage to tissues and bone compared to periodontal disease. Treating peri-implantitis is often more challenging than managing other infections, such as periodontitis.

Patients with a history of periodontitis face increased complications with dental implants. Therefore, not only should patients be free of periodontal disease before implant placement, but they also need to maintain healthy gums and natural teeth to prevent disease recurrence. Statistics indicate that approximately 22% of implants in patients with periodontitis develop peri-implantitis. Hence, prioritizing diligent oral hygiene at home and regular check-ups with dental professionals—dentists, periodontists, or dental hygienists—is imperative.

Detecting mucositis or peri-implantitis might not always be straightforward. Warning signs encompass increased gum bleeding during brushing or interdental cleaning, gum swelling, bad breath, or a foul taste in the mouth, and the implant, bridge, or dentures feeling loose. Regular dental check-ups aid in early detection and prevention of peri-implant mucositis or peri-implantitis. If any signs of inflammation around the implant surface emerge, seeking prompt evaluation from a dentist or periodontist is crucial.

Peri-implant Mucositis

Much like managing gingivitis, preventing and treating peri-implant mucositis involves good oral hygiene and professional cleanings done at least biannually. Patients previously affected by periodontitis must be vigilant as implants are less resilient to disease progression than natural teeth, necessitating regular monitoring to prevent or catch early signs of problems.

Peri-implantitis

Should peri-implant mucositis progress into peri-implantitis, various approaches are taken, depending on the extent of bone loss around the implant. Initially, subgingival debridement (deep cleaning), coupled with chlorhexidine mouthwashes and gels, aims to reduce bacterial deposits and control inflammation. Antibiotics may be considered. A re-assessment is carried out from 6 weeks following initial treatment.