Medically Reviewed by Jilian Lopiano
Table of Contents
Without a doubt, dental implants placement is the best option for the replacement of missing teeth. Since they not only help to recover the appearance and chewing function, but also work in a similar way to bone, so that there is no risk of long term bone loss. However, their care must be long term since, otherwise, there is a risk that can affect oral health: peri-implant diseases. We will tell you what they are, how they could be avoided and their treatment.
What are peri-implant diseases?
Dental implants are still a foreign body in the patient’s mouth, so during the first days after implantation there is an inflammatory process around the tissues where the implant is located, however, this should stop after maximum one week after implantation. Peri-implant diseases are a type of infectious-type inflammation around the area where the implant is, and usually occur as a result of inadequate hygiene.
Peri-implant diseases types
- Peri-implant mucositis. It is considered as the initial stage of peri-implant diseases in which there is a reversible inflammatory reaction in the tissues adjacent to the implant, without the bone on which it rests being compromised. It may be accompanied by bleeding or suppuration, so it is essential to go immediately to the dentist or implantologist who performed the treatment.
- Peri-implantitis. It is a peri-implant disease in which the inflamed tissue affects the soft and hard tissues surrounding the osseointegrated implant, resulting in loss of supporting bone. In addition to the blood and pus suppuration, the consequences of peri-implantitis can be so serious that they lead to the loss of the implant, however, by going to the specialist, the damage can be reversed and the tissues healed.
- Peri-implant failure. It is the most serious form of peri-implant disease that causes pus and blood suppuration, accompanied by pain and mobility of the implant.
The most frequent cause is incorrect hygiene that has led to food remains accumulation, causing the appearance of bacteria in the area near the implant. Peri-implant disease usually progresses more quickly than periodontitis since the defense mechanisms of the gingiva are more effective in preventing the spread of bacteria than those of the peri-implant mucosa, especially in particular situations that we describe below.
Peri-implant diseases risk factors
- Poor dental hygiene and bacterial flora. The bacterial plaque accumulation is the most common cause of mucositis and peri-implantitis. This plaque is made up of diverse bacterial flora, and when the number of bacteria increases, the disease progresses more quickly.
- Tobacco use. Smoking is one of the main risk factors for oral health in general, but when you have dental implants, the damage to peri-implant tissues is greater due to the vasoconstriction caused by nicotine, which hinders blood circulation, alters the cells of the immune system and the smoke adheres to the bacterial plaque, that is: smoking causes you to have a lower defense capacity, more bacteria, less oxygen and problems with wound healing, in addition to an exacerbation of periodontal disease. As if this were not enough, smoking causes greater bone loss.
- Previous periodontitis. People with a periodontitis history are at increased risk of peri-implantitis, especially if they have already suffered from bone loss.
- Diabetes. Diabetes mellitus is the systemic disease with the greatest impact on oral health, since poorly controlled glucose reduces the immune response and the healing capacity of tissues.
The diagnosis of peri-implant diseases is based on clinical history and observation to check the level of hygiene, bacterial plaque, soft tissue inflammation, the presence of bleeding, pus and mobility. With an X-ray, the supporting bone status can be assessed and, in some cases, microbiological cultures are requested in order to study the bacteria present in the peri-implant tissues.
Mucositis treatment consists of the elimination of plaque deposits through a deep dental cleaning, in addition to drugs or antibiotics prescription in order to stop the advance of bacteria. On the other hand, for peri-implantitis, bone loss must be stopped in addition to controlling the advance of bacteria. In some cases resective surgery is required to treat periodontitis.
In any case, it is important to visit a specialist as soon as possible, who will decide on the most appropriate treatment based on the type of disease, its progress and the supporting bone status.
Peri-implant diseases can be prevented with a correct technique of tooth brushing, use of rinse and floss to remove debris that causes the accumulation of plaque deposits around the teeth. In addition, after the placement of dental implants, it is important to attend check-ups at least every six months for a deep dental cleaning, in which plaque and calculus residues are professionally removed to keep both the implant and the rest of the teeth in perfect condition.
Schedule your appointment at The Dental District and start taking care of your teeth with our dental specialists in Tijuana, who will help you avoid complications and keep your oral health in good condition.