PERI-IMPLANTITIS

IMI Clinic

To date, rehabilitation through dental implants represents the most advanced and effective technique for both partial and total edentulism. This technique requires the insertion inside the bone of an implant, made in titanium that simulates the jaw bone itself. This in turn can be connected to an upper prosthetic structure that will replace the missing dental crown.

The term, peri-implantitis, refers to an infection caused by periodontal bacteria that manifests with inflammatory changes located in the tissues surrounding implants. Peri-implantitis is currently the most frequent cause of loss of implants.

It is divided into two types of inflammation of the peri-implant tissues:

Mucositis: inflammation that only involves the mucous membranes that line the implants. If intercepted, and treated, in a timely, and appropriate manner, this can be a reversible process.  

Peri-implantitis: inflammation that involves the mucosa, and also the bone, surrounding the implant. In this case, the lesion is visible in an X-ray. The symptoms are very similar to those of periodontitis: bleeding, depth of the pathological probing, suppuration, pain on percussion and colour changes in the gum surrounding the implant.

Peri-implantitis and periodontitis

In conditions of good oral health, the periodontal tissues are capable of forming a biological barrier. Nevertheless, it is important to realise that in the case of implants the type of ligament is much weaker than the one we have around a normal tooth. If this were to be lost following an accumulation of plaque and tartar, the bacterial contamination would reach the level of the bone, and would give rise to very rapid destruction of the same.

The bacterias that cause this type of infection are  mainly gram-negative bacterias, such as: Prevotella intermedia, Porfiromans gengivalis, Actinobacillus actinomicetemcomitans, Prevotella nigrescens, Treponema denticola, and Bacteriodes forsythus.

These bacterias are the same as the ones that cause periodontitis in natural teeth. For this reason, it is compulsory for the patient’s mouth to be healthy and free from periodontitis before installing implants, to ensure  that the bacterias cannot then infect the same implants.

peri-implantitis and periodontitis

In this photo  it is possible to see the plate before and after the treatment of the peri-implantitis, with the surgical microscope and laser. The growth of new bone can be observed and  will create osseointegration around the implant.

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Advanced technologies for the treatment of peri-implantitis
peri-implantitis and periodontitis

Peri-implantitis is diagnosed by searching for the signs and symptoms that we have spoken about previously. Thanks to to the microbiological tests,  comprehensive information about the bacteria found in the periodontal pockets can be given.

The treatment of peri-implantitis foresees a reduction in the bioburden thanks to an in-depth professional hygiene session carried out with the surgical microscope and with the use of laser: this is exactly in the same way as treating periodontitis and allows for bacterial decontamination with  a reduction in the inflammation.

It should be noted, that any failure of the implant therapy can easily be detected by the dentist before the implant surgery, through an analysis of the periodontal risk factors. In order to minise the  risk of losing the implant, with a subsequent loss in both biological and economic terms, it is essential for the mouth in which the implant is installed to be healthy and free of any outbreaks of periodontal bacteria.

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