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What causes implant failure?

The primary reasons for implant failure often stem from inadequate oral hygiene, a history of periodontal disease, and smoking. When oral hygiene is not carried out, bacteria accumulate on the implant surface, triggering inflammation of the surrounding mucous membrane, termed peri-implant mucositis.

If left untreated, this condition can escalate to a more severe state known as peri-implantitis, leading to heightened inflammation and subsequent bone loss around the implant. Ultimately, the implant can lose stability within the bone, necessitating replacement, sometimes requiring additional surgical procedures to restore lost bone structure.

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The importance of early detection of Peri-Implant Disease

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.

Treatment for peri-implant infections

Similar to periodontitis, peri-implant mucositis and peri-implantitis stem from bacterial plaque buildup. Therefore, treatments for these conditions adhere to similar principles used for managing gingivitis and periodontitis. The treatment varies based on the disease's severity around the implant.

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.


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.

If subgingival debridement does not resolve the inflammation, further steps are considered.. Surgical intervention becomes necessary if inflammation persists. Surgical approaches include bone regeneration with grafts, resective surgery to correct bone irregularities, or implantoplasty to modify the implant surface. Typically, a combination of procedures is employed for treating peri-implantitis.

Having thick gum tissue (“keratinised”) around the implant is important to prevent and reduce bone loss around implants. Insufficient soft tissue around implants can be rectified through techniques like palate gum grafts or collagen-based animal-derived grafts.

Early detection significantly enhances treatment success, emphasizing the importance of proactive oral hygiene and routine professional examination and cleaning after the implant is installed.

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