Peri-Implant Diseases

While dental implants have shown long-term success in most cases, complications occasionally occur that can result in peri-implant disease. Improper treatment planning and execution, as well as poor implant maintenance, have led to undiagnosed cases of peri-implant diseases, which can lead to bone destruction and eventually loss of the implant. There are two classifications of peri-implant diseases: peri-implant mucositis and peri-implantitis. Both diseases are characterized by red or tender gums surrounding dental implants. Risk indicators for these diseases include poor implant care (i.e., not brushing, flossing or getting regular dental check-ups), a history of previous periodontal diseases, infection from residual dental cement, smoking, and diabetes.

Peri-implant mucositis is confined to the soft gum tissues around a dental implant. Symptoms include red or tender gums with no signs of damage to supporting bone structures. The primary method for detecting early stages of peri-implant mucositis is probing dental implants to determine if gums are inflamed or bleeding. If detected early enough, peri-implant mucositis may be successfully treated and reversed without surgery. Treatment procedures include removal of gingival plaque and calculus, residual dental cement administration of antimicrobial agents and, if necessary, surgical treatment.

Peri-implantitis is also characterized by gingival inflammation around dental implants; however, this inflammation spreads beyond the gums and can cause progressive loss of supporting bone structures. Peri-implantitis is more difficult to diagnose. Probing can help determine gingival bleeding but is not a definitive marker for bone loss. For an accurate diagnosis, clinicians must use a combination of probing, periapical radiographs and, in some cases, cone beam computed tomography (CBCT) scans. Unlike peri-implant mucositis, peri-implantitis usually requires surgical treatment. Bone regeneration is possible if appropriate surgical techniques are used and the cause of the disease is eradicated.

Both peri-implant mucositis and peri-implantitis are both avoidable and treatable diseases. Patients who maintain an attentive oral health routine can avoid peri-implant diseases and ensure the success and longevity of their dental implants. If a problem does develop, treatment is most successful with early intervention. For this reason, it is recommended that patients with implants see their dentist or periodontist at regular intervals to monitor health and prevent the development of disease.

We firmly believe that that preventing the disease is better than treating it. For this reason, Drs. Mandelaris, Rosenfeld, and DeGroot carefully plan every patient’s implant placement to minimize the risk of complications. The CBCT technology used to diagnose peri-implantitis is also used to accurately measure each patient’s unique dental anatomy, ensuring that each dental implant is placed in the most ideal position to minimize risk and maximize esthetics and function. Each of our treatment plans take into account any potential risk indicators on an individual basis and assess whether additional steps should be taken to combat and prevent the disease.