Dental implants are artificial tooth roots placed in the jawbone following the loss of a natural tooth.
Peri-implantitis refers to inflammation of the implant site. If the inflammation initially affects only the mucous membrane, it is called mucositis. If the inflammation spreads to the bone, it is called peri-implantitis.
In the area surrounding an implant, bacterial colonies accumulate on the implant surface. These processes are caused by bacteria and result from inadequate oral hygiene.
Unlike periodontitis, which affects the periodontal tissues, peri-implantitis is an inflammation of the implants themselves.
Peri-implantitis can cause bone loss in the area around the implant © Alex Mit | AdobeStock
Peri-implantitis results from a combination of several factors:
Bacterial causes
Plaque and bacterial biofilm accumulate in the area around the implant. These can trigger inflammation around the implant.
Inadequate oral hygiene can contribute to peri-implantitis, and a lack of professional dental cleanings also increases the risk of peri-implantitis.
Systemic Risk Factors
Underlying conditions such as diabetes and osteoporosis are considered significant risk factors. Similarly, existing periodontitis can increase the risk of peri-implantitis. Radiation therapy received for another condition can also lead to peri-implantitis.
Implant-related factors
A rough implant surface facilitates plaque accumulation. Overloading due to bruxism (teeth grinding) can also damage the implant. Trauma during surgical procedures can also contribute to its development.
Voids in dental prostheses or poor fit can promote bacterial colonization.
In many cases, peri-implantitis begins with mucositis. This initially manifests as inflammation of the mucous membrane with symptoms such as:
- Redness
- Bleeding
- Swelling of the gums and
- a feeling of soreness
These symptoms are sometimes accompanied by pain in the area around the implant.
The gums around the implant may recede. The implant may become loose.
However, these typical symptoms are not always perceived as painful. Therefore, regular checkups should be performed to detect peri-implantitis at an early stage.
In the early stage, mucositis is present—an inflammation of the soft tissue without bone involvement.
If the inflammation is stopped at this stage, peri-implantitis can be prevented. Without treatment, the disease progresses, leading to bone loss around the dental implants. Advanced peri-implantitis can result in the loss of the implant.
Diagnosis is performed clinically by the dentist. Pocket depths are measured using a probe. Bleeding of the gums around the implant is an indicator of the condition. X-rays show whether the jawbone is affected and help distinguish peri-implantitis from mucositis. The goal is to detect peri-implantitis and treat it specifically.
Peri-implantitis can also result from treatment errors during implantation. Choosing an experienced implantology specialist minimizes this risk. Carefully sealing the interior spaces of the implant following the procedure prevents bacteria from entering.
During the mucositis stage, it is important to prevent the inflammation from spreading to the bone. This can be achieved through mechanical cleaning of the implant surface using a powder jet. Careful, professionally administered therapy reduces the bacterial load.
Once peri-implantitis has developed, the chances of successful treatment vary depending on the severity of the condition.
The treating dentist first removes the inflamed tissue and performs a thorough cleaning.
Possible cleaning procedures include:
- So-called scaling
- Smoothing the implant surface
- Powder jet cleaning, as well as
- Cleaning using a laser
In cases of severe findings, surgical treatment is necessary. Inflamed tissue is removed and, if necessary, bone grafting is performed. This surgically assisted procedure is intended to stabilize the implant.
The treatment of peri-implantitis is complex. In some cases, the implant must be removed.
Prevention begins immediately after the dental implants are placed. Key components include consistent oral hygiene, regular professional teeth cleaning, and checkups at the dentist’s office.
These measures significantly reduce the risk of peri-implantitis and can prevent the progression of an existing condition.
The earlier peri-implantitis is detected, the better the chances of recovery.
If left untreated, the inflammation progresses and leads to further bone loss. In the final stage, the implant may become loose.
Long-term care of implants is therefore crucial.
Treatment for peri-implantitis is not currently covered by statutory health insurance plans.
Privately insured patients can expect reimbursement for follow-up care and treatment of dental implants, as well as for any complications that may arise. This also applies to patients with supplemental dental insurance.
What is peri-implantitis?
Peri-implantitis is an inflammation around a dental implant that can affect both the gum tissue and the bone.
Can peri-implantitis be treated?
Yes, depending on the stage, peri-implantitis can be treated through cleaning, medication, or surgery.
How can I tell if there is inflammation around the implant?
Typical signs include redness, bleeding, swelling, and gum recession.
Is peri-implantitis curable?
If detected early, the prognosis is good. In cases of advanced peri-implantitis, treatment is more complex.
How can I prevent peri-implantitis?
Regular professional dental cleanings, good oral hygiene, and checkups at the dentist reduce the risk.
