What Is Peri-Implantitis?
There are two main inflammatory conditions that can develop around dental implants:
Peri-implant mucositis
Peri-implant mucositis is inflammation of the gum surrounding a dental implant without progressive loss of supporting bone.
Signs may include redness, swelling and bleeding when the area is examined or cleaned. When detected early, peri-implant mucositis can often be successfully managed with improved plaque control and professional treatment.
Peri-implantitis
Peri-implantitis occurs when inflammation around an implant is accompanied by progressive loss of the supporting bone.
It is more serious than peri-implant mucositis and may require more extensive treatment. The amount and pattern of bone loss, the position of the implant, the design of the restoration and the patient’s individual risk factors all influence treatment.
This distinction is important because treatment for inflammation confined to the gum may be quite different from treatment where supporting bone has already been lost.
What Are the Signs of Peri-Implantitis?
Peri-implantitis does not always cause pain, particularly during its earlier stages. Some patients may therefore be unaware that a problem is developing.
Possible signs include:
- bleeding from the gum around an implant
- red or swollen gums
- tenderness around the implant
- pus or discharge
- an unpleasant taste or smell
- gum recession around the implant
- increasing visibility of the implant surface or threads
- deepening of the gum pocket surrounding the implant
- bone loss visible on dental X-rays
- in advanced cases, loosening of the implant
Persistent bleeding around a dental implant should not be ignored, even if the implant itself feels comfortable.
What Causes Peri-Implantitis?
Peri-implantitis is a plaque-associated inflammatory disease. Bacterial biofilm accumulating around an implant can cause inflammation of the surrounding tissues and, in susceptible patients, progressive loss of supporting bone.
Several factors can increase the likelihood of peri-implant disease or make the tissues surrounding an implant more difficult to maintain.
These can include:
- a previous history of periodontal or gum disease
- inadequate plaque control
- irregular professional maintenance
- smoking
- diabetes, particularly when poorly controlled
- implant restorations that are difficult to clean
- residual cement around some implant restorations
- the position of the implant or restoration
- inadequate access for effective home cleaning
Patients who have previously experienced periodontitis require particularly careful monitoring of their dental implants.
How Is Peri-Implantitis Diagnosed?
Diagnosis requires a clinical assessment of the implant and surrounding tissues.
At Kew Periodontics, assessment may include:
- examining the gum surrounding the implant
- checking for bleeding or suppuration
- measuring the depth of the gum pockets around the implant
- assessing gum recession
- evaluating plaque control and access for cleaning
- examining the implant-supported crown, bridge or denture
- assessing whether the implant is stable
- taking dental X-rays to evaluate the level of supporting bone
- comparing current findings with previous records and X-rays where available
The aim is not simply to identify inflammation, but also to determine why the problem has developed and whether there are factors that can be corrected.
