Peri-implantitis & Peri-implant Mucositis

23 Jun 2012 | Treatments


Peri-implantitis is a severe inflammation around the neck of an dental implant. When an implant and its
surrounding soft tissues are non cleaned regularly an inflammation comparable to gingivitis may appear
caused by bacterial plaque. This condition is called mucositis and is reversible. You can recognize it as the
soft tissues start bleeding with the lightest touch. You can heal peri-implant mucositis with precise oral
hygiene procedures, daily rinses or local application of chlorexidine gel.


The next stadium is peri-implantitis, which manifests itself when daily oral hygiene procedures have been
insufficient for a longer period of time. On probing purulent exudate may a appear,  even though symptoms
sometimes are completely absent on the X-rays we can see evident bone loss around the implant. However usually redness, swelling, and bleeding are reported. A crown that spontaneously comes of the base of the implant might be an alarm bell that something is wrong. Peri-implantitis generally does not hurt. There is no pain involved, more commonly patients complain of a nuisance, a bad taste or bad breath.
Without any treatment you can loose your implant when the infection and the consequent bone loss have
arrived at a deeper level near the lowest spires of the screw.


The treatment protocol of peri-implantitis is still an issue as there is no official agreement between researchers on how to approach this new dental illness.Fortunately it has been found that Er-laser treatment is one of the most promising procedures, compared to brushes, chlorexidine  peroxide applications.
In the dental office Studio Moll we work with th Er,CR-laser and the treatment consists of a small operation uncovering the bone defect around the implant. With the laser we decontaminate the implant surface and bone walls and we remove
all the inflammatory soft tissues. We proceed with bone regeneration techniques, filling out the defect with
a bone substitute and we’ll cover all this with a resorbable membrane. With this procedure we try to
maintain the pink aesthetics, minimizing the loss of soft tissues and recovering functionality.


An other option is the resective surgery approach, in which the bone levels around the implant are
equalized by removing the crater walls, again with the laser or with he piezosurgery. This way the spires of
the implant remain above the soft tissues and for that reason  needs to be polished  to remove the rough surface which
would otherwise enhance plaque accumulation. This very effective method sacrifices however aesthetics, because you will have a very long implant with a long neck and with a big distance between the crown and the gums which requires much more attention. Once healed only correct daily oral hygiene procedures might prevent recurrence of these episodes.


Patients who suffer from periodontitis , diabetes or from other medical conditions, but also smokers, might be more subject to peri-implantitis. In fact before proceeding with implant treatment to substitute lost teeth at the dental office Studio Moll we evaluate your ability to maintain high oral hygiene levels and of course your medical status, if all critical conditions are completely under control. We need to know if you are a the right patient for this kind of treatment to be able to guarantee you long term success of the proposed therapy. Our recall-system for 6-monthly check-ups and professional cleaning prevent development of peri-implant mucositis in peri-implantitis.