periimplantitt

Periimplantitt is an inflammatory condition surrounding dental implants, involving the peri-implant mucosa and progressive loss of supporting bone. It differs from peri-implant mucositis by the presence of radiographic bone loss around the implant.

Causes and risk factors: The condition is driven by bacterial biofilm on implant surfaces, triggering a chronic inflammatory response. Risk factors include a history of periodontitis, poor plaque control, smoking and diabetes; mechanical overload and implant design or surface characteristics may contribute.

Clinical features and diagnosis: Signs include bleeding on probing, increased probing depths, swelling and sometimes purulent discharge. Radiographs show bone loss around the implant beyond initial remodeling. Diagnosis relies on clinical signs, imaging, and exclusion of other causes, such as mucositis without bone loss or mechanical overload.

Treatment and prognosis: Management aims to halt progression, control infection, and preserve the implant. Treatments include mechanical and ultrasonic debridement, antiseptics, and surgical decontamination with or without regenerative procedures. In severe cases or when bone loss is extensive, implant removal may be necessary. Long-term success depends on ongoing maintenance and control of risk factors.

Prevention: Emphasizes meticulous plaque control, regular maintenance, and modification of risk factors (e.g., smoking cessation, diabetes management). Comprehensive pre-implant assessment, proper implant placement, and prosthetic design reduce the risk of periimplantitt.