periimplantittia

Periimplantittia, usually called peri-implantitis, is an inflammatory condition around a functional dental implant that leads to loss of supporting bone. The inflammation extends from the soft tissues to crestal bone and typically occurs after a period of function. It is distinguished from peri-implant mucositis, which affects only soft tissue. Clinical signs include redness, swelling, bleeding on probing, and sometimes suppuration; radiographs show progressive marginal bone loss around the implant.

Etiology is multifactorial, with bacterial biofilm initiating the inflammatory response on implant surfaces. Local factors such as excess cement, inadequate debridement, and microgaps, as well as systemic factors like smoking, diabetes, and a history of periodontitis, increase risk.

Diagnosis relies on clinical findings and radiographic evidence: probing depths, bleeding on probing, suppuration, and bone loss beyond initial remodeling. Classification schemes describe severity by bone loss and pocket depth, but universal staging is not agreed.

Prevention emphasizes plaque control and regular maintenance; minimize risk factors. Treatment aims to control infection, halt bone loss, and restore function, using non-surgical debridement with antiseptics or local antibiotics, followed by surgical decontamination and possible regenerative procedures. In refractory cases, implant removal may be necessary.

Estimates of prevalence vary; peri-implantitis is reported to affect a notable minority of implants and patients after several years, commonly cited as about 10-20% of implants and up to 20-40% of patients. Ongoing research seeks to clarify risk factors, diagnostics, and optimal management.