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Peri-Implantitis describes a harmful inflammatory condition that can damage the union between the bone and the implant.
Peri-Implantitis Management
Historically, there was a perception that dental implants were immune to dental infections.
However, mounting evidence shows that dental implants can be susceptible to gum disease, just like natural teeth.
Similar to the range seen in periodontal (gum) disease affecting natural teeth, the impact and damage to the junction between the implant and bone can vary.
Hence, the immaculate cleaning and care of every implant is crucial for ensuring the long-term success of the treatment. For more details, read here.
The Peri-Implantitis Progression
It may start with an inflammatory reaction to bacteria left around the implant, where plaque accumulates and hardens over time, attracting more plaque.
This triggers the soft tissues and gums to respond by swelling and bleeding easily during brushing or minor agitation.
Following this, an invasive process starts with the loosening of the gum and soft tissues surrounding the dental implant, forming pockets.
The inflammation is triggered by toxins in bacteria, leading to additional bleeding and swelling.
If left untreated, the infection extends to the bone. Bacteria invade the bone, breaking it down and causing further tissue damage.
The osseointegration process, where the bone connects with the threading in the dental implant during the healing phase, becomes damaged. Consequently, the bone supporting the implant starts to deteriorate, resulting in implant loosening.
As dental implants are often covered with a crown, bridge, or prosthetic (denture), any biting pressure worsens the infection around the implant.
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Peri-Implantitis Causes
Poor Oral Hygiene: Neglecting regular hygiene appointments and sub-standard at-home teeth cleaning can lead to the accumulation of infection.
Ill-Fitting Crown or Prosthesis: An improperly fitting crown or prosthesis hinders effective cleaning.
Overly Bulbous Prosthesis or Crown: Excessive size can impede easy cleaning.
Loose Screw in a Screw-Retained Crown: A loose screw can act as a plaque trap.
Residual Cement: Failure to remove excess cement during crown fitting creates a plaque trap.
Incorrect Implant Position: If the positioning of the implant encroaches the 3-4 mm biological barrier, resulting infection can easily invade the osseointegration zone.
Incorrect Loading: Unbalanced and unstable loading from the prosthesis, bridge, or crown surface can lead to mechanical stress on the implant, causing biological degradation.
Incompatible Implant Design: Using an implant design that does not suit the patient's mouth can lead to peri-implantitis.
Accurate Diagnosis
Achieving this involves a thorough clinical examination of the tissues surrounding the implant and a radiographic assessment. Learn more.
The dentist will examine various aspects of the dental implant, including:
- Chewing Load
- Gingival Examination
- Both Vertical and Horizontal Bone Loss around the Implant
- Any loosening of the Gum
- Signs and Symptoms of Infection
- The amount of implant movement
Types of Peri-Implantitis
Peri-Implant Mucositis occurs when an infection affects the soft tissues and gums surrounding the implant, starting an inflammatory process. Statistics indicate that 30% of dental implant failures result from gum disease around the implant.
Peri-Implantitis involves both soft and hard tissue deterioration. It starts as a gum infection but escalates to aggressively affect the bone. This progression leads to bone detachment and disintegration.
Symptoms of Peri-Implantitis:
The symptoms vary based on the severity and type of peri-implantitis:
- Bleeding and changes in gum colour
- Swelling and oedema
- Presence of pus, pocketing, and pain
- Instability of the prosthesis
- Gum loosening
- Bone loss and disintegration
- Implant looseness
Peri-Implantitis Treatment
Our approach to treatment depends on whether the diagnosis is Peri-Implant Mucositis or Peri-Implantitis. Irrespective of the diagnosis, the initial protocol focuses on managing and controlling the infection.
Treatment comprises the removal and debridement of the infected tissue, a procedure that can be conducted under local anaesthesia.
Gum surgery may or may not be necessary, and regenerative and specialized surgical techniques might be involved. We prioritize the care of nervous patients.
To clean the implant site, it's crucial to use instruments softer than titanium. This can involve non-metallic tips, resin/carbon fibre curettes, or an ultrasonic cleaner.
Preventing Peri-Implantitis
Prioritising prevention over subsequent treatment protocols is paramount for the best outcomes, with early detection playing an important role.
Minimizing risk factors, particularly smoking, is essential to preventing the problem.
Mechanical cleaning is typically necessary, and laser therapy is now available to enhance healing and bio-stimulation of the bone.
Treatment is often supplemented with antibiotics, followed by a healing phase and subsequent re-assessment.
Starting a rigorous at-home tooth cleaning program from the moment you decide to undergo implant placement is crucial.
Regular appointments with our hygiene therapist are essential for ongoing monitoring before, during, and after your dental implant treatment.
Before and after gallery
Dental Implant Questions
- Lifespan of Dental Implants:
- Can Dental Implants last Indefinitely? Once the implant integrates with your jawbone and tissues, the titanium implant functions like a natural root. The lifespan of your implant also relies on the care and maintenance of your oral health.
- Pain and Discomfort: Is Pain Associated with Dental Implant Placement? When we place the implant, we are careful to carry out a pain-free procedure and if required various sedation methods suitable for nervous patients.
- Age Requirement for Dental Implants: Is There a Minimum Age for Dental Implant Treatment? While there is no specific age limit, our dentists recommend individuals to be over 18 for the dental implant procedure.
- Safety of Dental Implant Treatment: We employ Computer Guided implant placement techniques. We also employ comprehensive planning systems to ensure the success and safety of the implant treatment.
- Value of Dental Implants: Assessing the Benefits of Dental Implants: A dental implant offers numerous oral health advantages, including smile enhancement, stabilisation of adjacent teeth, and protection against gum disease.
- Pain in the Implant Process: Managing Discomfort in the Implant Process: Some slight discomfort may following the placement of a new implant, which minimized through modern anaesthetics. Post-procedure, swelling and slight aching may occur for 1-2 days. Many patients undergo multiple implants in a single day with minimal pain or distress. Existing patient have described this discomfort as no worse than that experienced after a tooth removal.
Implant Guide
Implants undergo colour matching and meticulous shaping to seamlessly harmonize with your natural teeth. Implant teeth are virtually indistinguishable from real teeth.
Long-Lasting Dental Implants
Once the implant integrates with your jawbone and surrounding tissues, the artificial titanium structure functions just like a natural root.
When we insert a titanium implant into the jawbone, it becomes an integral part of your oral structure.
This provides numerous health advantages, such as slowing or stopping bone loss, reinforcing the jawbone's structure, and diminishing the likelihood of gum disease due to better cleaning when compared to dentures.[Learn More.]
Longevity of Dental Implants
When appropriately cared for, dental implants boast a lifespan ranging from ten to twenty-five years or even longer.
Dental implants are beneficial for:
- Tooth loss due to trauma, accidents, or injuries
- Missing teeth resulting from gum disease or insufficient bone
- Substituting old, worn, or fractured dentures
- Integrated treatments like Implant-Retained Dentures
- Offering both removable and fixed options
- Addressing individual tooth loss or entire arches in a single session
The long term success of your implant depends on your commitment to your oral health. [Discover more.]
