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How to Manage Peri-implantitis (Part II)

How to Manage Peri-implantitis (Part II)

Author: Canadian Dentures/Wednesday, May 11, 2016/Categories: Tips & Tricks

Denturists can correct your Dental Implants

Many candidates for peri-implantitis treatment are usually patients who had their implants done by inexperienced dental professionals. Dental implants with problems should be corrected by a denturist who routinely performs this procedure.

The treatment process involves a series of steps:

Step 1: Assessment of the dental implant 

Before any treatment can commence, the denturist must check the implant (or crown/bridge) for correct fabrication. This step usually requires x-rays and 3D scanning to see the inside surface.

Step 2: Diagnosis 

The main cause of peri-implantitis is excess cement oozing beyond the abutment, such that it penetrates the gum near the bone, becoming an irritant. This is why it is important to make implants/ crowns that are attached using screws instead of cement. When cement is used, it should be of the right type, and the right technique used by a skilled and experienced denturist.

Peri-implantitis can also be caused by a broken or loose abutment screw that may have been improperly torqued. A broken abutment screw usually occurs when the patient has a heavy bite, and a specially made crown was not used to protect the implant.

In some cases, gum disease can cause peri-implantitis. Here, further analysis is necessary to determine whether the implant can be saved through simultaneous bone graft.

Step 3: Treatment

The objective of peri-implantitis treatment is to prevent bone loss from progressing any further and maintain your dental implants. There are different ways to manage peri-implantitis, including:

1. Local debridement 

The implant is cleaned using instruments that are softer than titanium to avoid roughening the implant surface. The process may involve polishing with a rubber cup and paste, interdental brushes, floss, or using plastic scaling instruments.

2. Implant surface decontamination 

This technique is based on studies showing that it is possible to eliminate bacteria from different titanium surfaces without modifying the implant surface. The four common implant surface decontamination techniques include: air-powder abrasion alone; air-powder abrasion followed by citric acid application; the use of gauze awashed in saline followed by the application of citric acid; and the use of gauze soaked alternately in 0.1 percent chlorhexidine and saline.

3. Anti-infective therapy 

Localized peri-implant issues without any other infections can be successfully treated using the local application of antibiotics, such as tetracycline fibers. The treatment helps to maintain a high level of antimicrobial agents in the affected site for a limited period, so it may need to be repeated as recommended by your denturist.

4. Surgical treatment 

Surgical resection is mostly recommended for implants in non-esthetic sites. There are different surgical treatment techniques, including autogenous bone grafts alone; membranes alone; autogenous bone grafts covered by membranes; and control access flap procedure. The combination of autogenous bone grafts and membrane cover is claimed to result in the largest amounts of bone regeneration and osseointegration compared to the other techniques.

Final note

In cases of advanced bone loss such that it is not possible to save the implant, then it has to be removed, followed by explantation. Fortunately, the techniques for managing peri-implantitis have advanced over the last decade, so patients can successfully recover from peri-implantitis without losing that implant. For further assistance from our denture specialists, please contact our Calgary-based Canadian Denture and Implant Centres.

Article Source:  Management of peri-implantitis published on National Center for Biotechnology Information

Photo Credit: Can Stock Photo

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