What is peri-implantitis and how to prevent it?
Dental implants are one of the most durable, resistant and comfortable solutions for the loss of teeth. They are currently the restorative treatment with the highest success rate thanks to the great advances in dentistry and the techniques and technologies used in surgical intervention.
However, the success of the treatment and its durability are also related to the state of health of the rest of the teeth and gums. Just as it happens when all the teeth are still preserved, oral problems can also arise with implants, peri-implantitis being one of them.
What should you know about peri-implantitis if you have dental implants?
- What does peri-implantitis consist of?
- What are the signs of peri-implantitis?
- What causes peri-implantitis?
- How can peri-implantitis be prevented?
- How is peri-implantitis treated?
1. What is peri-implantitis?
Peri-implantitis is an inflammatory process that affects the tissues surrounding the implant, i.e. the mucosa, and can lead to implant failure. It is therefore essential to address this oral pathology in time, otherwise the infection can destroy the bone tissue where the implant screw has been integrated.
This oral disease, which is the most serious of the peri-implant diseases, has a first stage known as peri-implant mucositis, when only the soft tissues have been affected and which, if left untreated, leads to peri-implantitis.
Roughly speaking, mucositis would be equivalent to gingivitis in the gums surrounding the original teeth, while peri-implantitis would be an infection similar to periodontitis or pyorrhoea, but affecting the bone supporting the implant, leading to the fall of the screw and crown.
2. What are the signs of peri-implantitis?
It is worth mentioning that the signs begin to appear in that early stage that we have mentioned and which corresponds to peri-implant mucositis. These are:
- Inflammation and redness.
- Bleeding and pus oozing.
- Pain during chewing.
- Recession of the gum.
- Implant mobility.
Furthermore, according to a report published by SEPA in 2019, “the progression of peri-implantitis is faster than that observed in periodontitis” and “patients with a history of severe periodontitis” have a higher risk of suffering from it. This is why it is essential to know the causes of this pathology in order to prevent it.
3. What causes peri-implantitis?
It is important to note that not all patients are at risk of developing peri-implantitis. However, between 5 to 10 years after surgery, 20% of patients may develop peri-implantitis due to:
3.1. Poor oral hygiene.
Lack of proper oral hygiene is the main cause of most oral conditions, including peri-implantitis. The accumulation of bacteria or oral biofilm is largely due to poor oral hygiene.
The proliferation of bacteria can cause wear of the mucosa, the appearance of infection and affect the supporting bone, leading to its destruction. For this reason, it is just as important to ensure a good oral cleaning habit after each meal, as it is to have regular check-ups and cleanings that allow the tartar accumulated over time to be completely and effectively eliminated.
In fact, these check-ups could determine whether the patient is suffering from peri-implant mucositis which, as we have mentioned, is a state prior to peri-implantitis, easier to treat and prevent bone destruction.
3.2. Tobacco consumption.
Smoking is another risk factor for peri-implantitis. Smoking, which is already a habit that can affect both overall health and oral health in particular, can affect proper recovery after implant surgery, increasing the chances of dental implant failure (or, as it is colloquially known, rejection). Therefore, reducing (or even better eliminating) this habit can minimise oral health problems after implant placement.
4. How can peri-implantitis be prevented?
As we say, prevention is always the best treatment. Therefore, in order to avoid the appearance of this pathology once dental implant surgery has been performed, it is essential to take five points into account:
- Follow the recommendations and maintenance advice of the specialist.
- Go to scheduled and regular check-ups to control the state of oral health.
- Have professional cleanings as often as recommended by the specialist.
- Be thorough and careful when performing oral and implant hygiene at home.
- Avoid smoking, especially during the osseointegration phase.
5. How is peri-implantitis treated?
In the past, when faced with peri-implantitis, specialists were forced to remove the implant. But nowadays, advances in dentistry have made it possible to find therapies such as subgingival debridement or subgingival scaling to eliminate the inflammation and restore the damaged tissue, provided that the peri-implantitis is diagnosed in time and the tissues are not seriously affected.
In these cases, the prescription of antibiotics would also be necessary. Subsequently, and at a maintenance level, it would be important to prescribe a series of dental prophylaxis to ensure that bacterial plaque does not accumulate and cause this problem again.
