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Peri-implantitis - symptoms & treatment of inflammation around the implant

Gum inflammation in the area around a dental implant can not only be painful, it can also sometimes go unnoticed. If left untreated, they can even lead to the loss of the implant in the long term.


At our dental practice in 1060 Vienna, oral surgeon Dr. Dr. Felix Wick performs peri-implantitis treatments. Our aim is to combat the inflammation with the appropriate conservative or surgical measures and to ensure that the implant is preserved.

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What is peri-implantitis?

01
Bacterial infections: Bacterial biofilms, similar to those that cause periodontitis, are major factors.
02
Poor oral hygiene: Inadequate care can lead to the accumulation of plaque and bacteria around the implant.
03
Smoking: Smoking increases the risk of peri-implantitis by impairing oral health.
04
Pre-existing diseases: Patients with pre-existing periodontitis have a significantly higher risk.
05
Overloading the implant: Excessive chewing pressure or incorrect loading can first lead to bone resorption and then subsequently to inflammation around the implant. However, this has not been fully clarified by scientists.
06
Inadequate implant placement or quality: Errors during implantation or inferior implants can promote inflammation as well as material failure.
07
Systemic diseases: Diabetes and other systemic diseases that affect the immune system increase the risk.
08
Genetic factors: Certain genetic predispositions can play a role.

Symptoms of peri-implantitis

Typically there is bleeding and inflammation of the gums around the implant, sometimes accompanied by pain in this area. In many cases, it is also an incidental finding during a dental check-up. This is often accompanied by the formation of pus or increased bleeding of the gums during probing with a dental probe. In the long term, the gums often recede. This regression is also followed by a regression of the bone around the implant. Once this has reached a certain level, the implant can become loose and must eventually be removed. 

 


Bone loss around the implant is also frequently observed. Bone recession is the only symptom that can be visualized by X-ray and can be used for long-term monitoring.

How is peri-implantitis diagnosed?

Peri-implantitis is diagnosed using a combination of clinical examinations and imaging procedures. First, the gums around the implant are examined for signs of inflammation. The dentist also checks for possible loosening of the implant. X-rays are crucial to assess bone loss around the implant. In some cases, additional tests such as pocket depth measurement by probe or microbiology tests to identify specific bacteria may be required.

Dr. Dr. Felix Wick | Brand Whiteballs

How is peri-implantitis treated?

The treatment of peri-implantitis depends on its severity:

 

Mild peri-implantitis: Professional tooth and implant cleaning

Mild inflammation in the soft tissue around a dental implant can generally be treated well with professional oral hygiene and an improved cleaning technique and is therefore transient.

 

Figure 1: Mild inflammation around a dental implant
Source: Nobel Biocare

Advanced peri-implantitis: treatment with bone augmentation

If the inflammation around the dental implant has already led to bone loss, the treatment is much more complex. The primary goal is now to stop the inflammation and build up the bone.

 

In some cases, it is also possible to rebuild the lost hard and soft tissue, i.e. to replace the bone and restore a healthy oral mucosa.

 

In our Vienna practice, the treatment method based on the principles of implant cleaning with the Galvo Surge, bone augmentation and the addition of PRF (autologous blood therapy) has proven successful.


The aim of this therapy is to preserve the implant and, above all, the prosthetic work integrated on it, such as crowns, bridges or dentures, in the long term.

 

Figure 2: Advanced inflammation around a dental implant
Source: Nobel Biocare

Last alternative: removal of the implant

If nothing can be achieved with this method or multiple attempts at treatment, the implant must be removed (explantation). We then allow the former implant site to heal for at least two months until the local bone has recovered. In most cases, however, it will probably take a little longer. 

Additional bone augmentation may also be necessary to restore the original conditions. This depends on how much bone has been lost due to the inflammation and implant removal. 

 

Figure 3: Removal of the implant in the final stage of peri-implantitis
Source: Nobel Biocare

Conclusion

In many cases, treating the implants and the surrounding inflammation is the only way to be able to leave the prosthetic restoration in the mouth.

Frequently asked questions about peri-implantitis

How long does the treatment of peri-implantitis take?

The duration of treatment for peri-implantitis varies depending on the severity and individual case. Mild cases can be treated within weeks, while severe cases can take several months to a year. Regular follow-up examinations are important to monitor the healing process.

What are the causes of peri-implantitis?

There can be many causes of peri-implantitis: Bacterial infections, poor oral hygiene, smoking, systemic diseases such as diabetes, poor implant placement or excessive stress on the implant.

How to prevent peri-implantitis?

With existing dental implants, thorough oral hygiene and regular check-ups with your dentist are the key measures for preventing infections.

What does peri-implantitis treatment cost?

The treatment costs also depend on the severity of the treatment. Generally speaking, it is always cheaper than a new restoration with implants and crowns.

Is peri-implantitis treatment painful?

The treatment is usually painless. For deeper treatments, a local anesthetic is also used.