An Overview of Peri-Implant Conditions
Dental Implants have been successfully utilized by practitioners to replace missing teeth. They have shown to yield high survival and success rates in many long term studies. However if subjected to specific risk factors infectious peri-implant diseases may develop. When speaking about Peri-Implant diseases, there are:
1. Peri-Implant Mucositis, which is gingival inflammation that surrounds the implant without bone loss, 2. Peri-Implantitis is the presence of gingival inflammation coupled with bone loss.
Both of these conditions can be treated with proper diagnosis, treatment and patient compliance.
Both Peri-Implant conditions ( Peri-Implant Mucositis & Peri-Implantitis) arise from the presence of bacterial plaque that leads to inflammation . The colonizing bacteria first causes local inflammation at the implant site and then leads to a complex host response resulting in considerable tissue damage. Some of the bacteria that have been identified in infected areas are Staphylococcus aureus, human Cytomegalovirus, and Epstein Barr virus.
Besides the presence of bacteria, there are other predisposing factors leading to these conditions.
1. Implant Factors: Material, Design, Surface Properties of the Implant.
2. Clinician Factors: Surgical Technique, Restorative Treatment.
3. Patient Factors: Medical History, Quality/Quantity of Bone.
Early detection is key, just like with any other condition, when diagnosing Peri-Implant diseases. The clinician should do a thorough restorative, periodontal, and radiographic exams. Periodontal charting at every visit allows for a comparison of readings over-time; it should also show presence of bleeding and suppuration at the implant site. The tissue characteristics (eg: swollen, color)should be noted as well as any mobility and pain on percussion of the implant.
There are three ways to manage the Peri-Implant conditions. They are as follows:
1. Non-Surgical Treatment: It is the first line of defense. Involves mechanical debridement of plaque, calculus, and all other debris.
2. Surgical Treatment: Used when non-surgical treatments have yielded no results. Involve Resective and Regeneration techniques to improve implant access and bone grafting.
3. Explantation: Used when all other surgical and non-surgical techniques have yielded zero results. Involves removing a “Hopeless” implant.