periimplantit

Peri-implantitis, also called periimplantitis, is an inflammatory condition around dental implants. It involves inflammation of the peri-implant mucosa and progressive loss of supporting bone, contrasting with peri-implant mucositis, which lacks bone loss.

Causes and risk factors: The primary driver is bacterial biofilm on the implant surface. Contributing factors include poor plaque control, prior periodontitis, smoking, diabetes, poor implant placement or prosthetic design, insufficient maintenance, and biomechanical overload.

Signs and diagnosis: Redness, swelling, tenderness, bleeding on probing, and sometimes purulent discharge. Radiographs show progressive crestal bone loss. Diagnosis combines clinical signs with radiographic evidence of bone loss around the implant.

Prevention: Regular maintenance, meticulous oral hygiene, and smoking cessation. Managing systemic conditions, ensuring proper implant placement and prosthetic design, and scheduling regular radiographs help with early detection.

Treatment: Depends on severity. Non-surgical therapy includes mechanical debridement with implant-specific tools, antiseptic irrigation, and sometimes antibiotics. Advanced cases may require surgical debridement, regenerative procedures with bone grafts or membranes, or resective surgery. In some instances, implant removal is indicated.

Prognosis and epidemiology: Prognosis is variable; early detection improves outcomes. Prevalence estimates vary; reviews often cite roughly 10–20% of implants affected within 5–10 years, depending on criteria and population. Risk factors include smoking, poor hygiene, prior periodontitis, and systemic diseases.

See also: peri-implant mucositis, dental implant.