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Peri-Implant Disease Treatment

Peri-Implant Disease Treatment

Although dental implants do not develop cavities like that of natural teeth, dental implants are just as susceptible to gum disease as natural teeth. In fact, when gum disease develops around dental implants, it can be more difficult to treat than gum disease around natural teeth.

Peri-implant disease refers to a group of conditions that develop around dental implants. Two main categories of conditions under the umbrella of peri-implant disease are implant mucositis and peri-implantitis. Implant mucositis is the counterpart of gingivitis around natural teeth. Peri-implantitis is the counterpart of gum disease around natural teeth. Peri-implantitis involves bone loss around implants, and when severe, the implant screw threads can become visible inside the mouth and are not covered by gums (usually implant screw threads should be inside the jawbone covered by the overlying gums). Like gum disease, individuals with peri-implant disease sometimes may not experience any discomfort. Nevertheless, when the disease destruction is considerable, individuals with peri-implant disease may experience pain, bleeding, pus, bad breath/taste, and gum recession around dental implants with implant thread exposure to the oral environment. 

Causes of Peri-Implant Diseases

Like gum disease, peri-implant disease is caused by bacterial colonization along the crown and the screw surface of dental implants. Unlike natural teeth in which the root portion of the teeth is usually smooth, the surface of the implant screw is intentionally designed to be rough to facilitate the in-growth of jawbone. Hence, when bacteria gain access to the rough implant screw surface, it is very difficult for clinicians to remove bacteria because they live in microscopic pits on the rough screw surface.

Both patient and dentist can contribute to the development of peri-implant disease. If the patient does not practice good oral hygiene around dental implants and does not attend his/her regular implant cleaning appointments, the bacteria will grow around implants leading to peri-implant disease. If the dentist who cemented the final implant crowns for the patient did not completely remove the cement, then the residual cement around the implants acts like tartar around nature teeth that can encourage the colonization of bacteria leading to peri-implant disease.

Surgical Implant Decontamination

Treatment for implant mucositis involves non-surgical implant debridement, and the disease can often be reversed back to implant health. Treatment for peri-implantitis is more complicated and involves surgical implant decontamination. To date, there is no one way to treat peri-implantitis. However, common to all treatment is implant surface decontamination which can be performed with titanium instruments, local delivery of antibiotics, laser technology, and others.

Bone Grafting Around Implants

Peri-implantitis necessitates surgical therapy that involves the opening of the gums around the implants and jawbone, decontamination of implant screw surface, and placement of bone grafting materials if bone loss pattern around implant is favorable. Sometimes it may be necessary to remove implant abutment and crown when treating peri-implantitis.

Gum Grafting Around Implants

In certain situations when gums around dental implants have receded, a gum grafting procedure can be performed to grow back the lost gums. Gum recession around dental implants can be caused by gum inflammation around implants, bone loss around implants, and mal-placement of implants.