Peri-implantitis is an infectious disease that causes inflammation of the gum and bone tissue surrounding an already integrated dental implant, resulting in the loss of supporting bone.
Bone loss around an implant
Dental implants for supporting prosthetic tooth replacement have been used for many years with satisfactory results with regard to restoring the patient’s esthetics and function, as well as longevity of the treatment results. However, there are some long-term risks that may be associated with dental implants, such as the loss of supportive bone even in cases of successful osseointegration.
There are many factors that contribute to the loss of crestal bone surrounding an implant, but the primary cause is local inflammation following the start of peri-implant diseases. Peri-implant diseases refer to inflammatory lesions that affect the surrounding peri-implant tissues, and include peri-implantitis and peri-implant mucositis. While the latter involves inflammatory lesion limited to the mucosa surrounding an implant, peri-implantitis is an advanced case of the same, affecting the supporting bone and leading to loss of osseointegration.
Peri-implantitis can be influenced by:
● Patient-related factors including systemic disease such as diabetes and osteoporosis, and prior dental history, such as periodontitis
● Social factors such as smoking, drug abuse, and inadequate oral hygiene
● Parafunctional habits such as malocclusion and bruxism
Besides these, iatrogenic factors or treatment-related factors such as loose implant placement, overheated bone, implant size excessively big, vertical bone grafting, faulty restorations, and cement left following restoration delivery can contribute to the development of peri-implantitis.
Common signs of peri-implantitis include:
● Bleeding at the gum line
● Deep gum pockets
● Metal threat exposure – long tooth
● Pus coming out from the gums and implants – causing a bad taste
● Plaque buildup and red or purple/blue gums
● Progressive loss of supporting bone – viewed on X-rays
Peri-implantitis is not always symptomatic, and many patients do not experience any pain except for some tenderness or dull aches when they touch or brush the area. But in severe cases, the glands in the patient’s neck may become swollen.
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