Peri-implantitis is what doctors call an implant bed inflammation in dental implants. The preliminary stage of the so-called peri-implantitis is called mucositis and describes an inflammation of the mucous membrane surrounding the implant neck. In the advanced stage it is an irreversible disease; the earlier the peri-implantitis is detected, the higher the chances of complete healing.
What is peri-implantitis?
Many people who have dental implants are often unaware of the possible health risks. This also includes peri-implantitis, which describes an advanced inflammatory process in the gums and only occurs when implantological interventions have been carried out. The inflammation spreads to the depths of the jawbones. See electronicsencyclopedia for Slang Hepatitis A.
In the early stages, doctors still speak of mucositis or peri-implant mucositis. Mucositis is a tissue inflammation of the gums surrounding the implant. After treatment, the mucositis goes away. However, if the doctor finds peri-implantitis, an irreversible condition has already occurred, which sometimes also causes bone loss. If the peri-implantitis is treated too late or not at all, the patient must expect to lose his dental implant.
The cause of peri-implantitis can be compared to periodontitis. Because plaque also accumulates as part of periodontitis or peri-implantitis. If the affected person removes this plaque irregularly or not thoroughly enough, bacteria begin to form at the gum line, which can work their way up to the implant neck. The patient then complains of pain.
Insufficient or missing oral hygiene can also be responsible for the development of peri-implantitis. The following factors also promote peri-implantitis: smoking, untreated periodontitis, diabetes mellitus, medication (such as immunosuppressants), a periodontal history, hormonal changes, osteoporosis.
However, prolonged stress, poor implant or dental care, irregular dental check-ups and inadequate healing of the implants can also promote peri-implantitis – it can not only be caused by the person affected, but also by the doctor treating it.
Symptoms, Ailments & Signs
At the beginning, the affected person feels slight pain when he touches his gums on the edge of the implant. Sometimes the gums in the vicinity of the implant can turn reddish or patients also state that the implant causes pain. Those factors can be the first signs of inflammation; even with the slightest symptoms, a dentist should be consulted.
If the peri-implantitis is already in an advanced stage, the affected person complains of bone pain, which is mainly localized in the jaw region. The gums recede, the dental implant feels “loose”. Sometimes the feeling that the implant is “loose” can be another sign of peri-implantitis.
The symptoms are relatively difficult to interpret; for this reason it is important that regular dental check-ups are observed. Because the dentist not only checks the gum pocket depth, but can also use marker tests to determine within a very short time whether the dreaded peri-implantitis is present.
Diagnosis & course of disease
In order for peri-implantitis to be diagnosed, two steps are essential. On the one hand, the classic clinical diagnosis of the area takes place; For this, the doctor uses so-called periodontal probes. If bleeding occurs, which can also be an indication of discharge of pus, the suspected diagnosis of peri-implantitis can be made.
Using X-rays, the doctor can get a precise picture of the condition of the affected region. Intraoral dental film recordings are made to confirm the suspected diagnosis. The course and prognosis depend on the severity. This means that the doctor checks the breakdown of the bone in order to be able to make any predictions.
Respective and augmentative treatment methods can very well bring the peri-implantitis to a standstill; in many cases complete regeneration of the bone can also be observed. In some cases, however, only the removal of the implant is possible. Only when the doctor has removed the implant can the bone regenerate and be rebuilt. After regeneration, a new implant can be placed.
In most cases, peri-implantitis is associated with severe pain in the mouth and on the teeth. Those affected are also significantly restricted in the intake of food and liquids, so that it is not uncommon for them to be underweight or suffer from deficiency symptoms. Dehydration can also occur as a result of peri-implantitis.
The pain from the teeth often spreads to the ears or head, so that most of those affected also suffer from depression or psychological problems because the pain is permanent. This condition is treated with antibiotics or radiation. As a rule, there are no special complications.
The patient’s life expectancy is also not affected or reduced by this disease. However, in severe cases, the implant must be completely removed and replaced. If left untreated, the inflammation can spread to neighboring teeth and affect them. If the bone has already been broken down by the disease, it must be filled with a filling material. However, there are no further complications.
When should you go to the doctor?
Dental implant wearers who suddenly notice a sweetish bad breath or pain when brushing their teeth should consult their dentist . Peri-implantitis is a serious condition that needs to be diagnosed quickly. At the latest when there is a noticeable loosening of the implant, medical assistance is required. If the symptoms occur shortly after the dental implant has been inserted, the responsible doctor must be informed immediately. There is a particular risk if the patient does not maintain adequate oral hygiene or suffers from other diseases of the teeth or gums.
If these risk factors are present, a doctor should be consulted immediately for the symptoms mentioned, who can diagnose and treat the condition. The first point of contact is the dentist. The doctor can examine the oral cavity and the implant and, if necessary, consult the responsible surgeon. Depending on the severity of the condition, peri-implantitis can be cured with the help of rinsing solutions or professional cleaning of the implant. In addition, the patient must optimize oral hygiene at home in order to avoid the spread of the inflammation in the long term.
Treatment & Therapy
The top priority of treatment is the complete removal of the bacteria that subsequently triggered the peri-implantitis or inflammation. The treatment depends on how far the inflammation has progressed or how aggressive the bacteria actually are.
If the peri-implantitis is still in the early stages, special rinsing solutions can lead to success. Professional mouth cleaning and dental hygiene as well as professional cleaning of the dental implant can also lead to success. In many cases, the affected person must also take antibiotics. Another option is laser therapy (photothermal therapy, also known as PTT).
Using laser therapy, doctors can remove bacteria and germs that are responsible for the breakdown of tissue. In this way, any breakdown of tissue can be stopped. However, if the doctor has diagnosed advanced peri-implantitis, which has also caused bone loss, in many cases only surgery can help. The doctor fills the bone pocket with bone replacement material so that the implant can be re-anchored in the jawbone.
Outlook & Forecast
The prognosis for peri-implantitis depends on the extent of the disease and the cause of its origin. The treating dentist or oral surgeon can provide precise information about the prospects.
Oral hygiene is an important factor in peer implantitis, both in terms of the development and the healing of this inflammatory disease. Therefore, the cooperation of the patient is very important with regard to the best possible prognosis. You should brush your teeth very thoroughly and, of course, regularly. Once or twice a year, the PZR, the professional teeth cleaning by specially trained assistants, which is covered by most health insurance companies, is important. The dental practice also offers a special cleaning of the implants. This is also recommended once or twice a year and contributes to a favorable prognosis with regard to peri-implantitis.
Smoking can increase susceptibility to inflammation while masking symptoms. Nicotine is often associated with a negative prognosis.
The load on the implant is also closely related to the prospects of peri-implantitis. The healing phase of the implant, which is determined by the dentist, must be observed with regard to the load. The prognosis of peer implantitis can be worse if the patient puts more strain on the tissue than recommended by the dentist.
In order to prevent peri-implantitis, oral hygiene is of course the top priority. This is the only way for the affected person to avoid deposits and plaque, which subsequently lead to bacteria. Furthermore, professional implant cleaning and six-monthly or annual dental checks and also professional tooth and implant cleaning are of essential importance.
The dreaded complication of peri-implantitis is an inflammatory reaction around the area of the implant. This can often be prevented by regular and thorough cleaning, which is why oral hygiene is of great importance in the context of aftercare.
After the dental implant has been inserted, the dentist will provide you with precise information about the precautionary measures included in the aftercare in order to prevent the development of periimimplantitis as best as possible. The cleaning technique is just as important as regularity and the use of dental floss or interdental brushes and mouthwash.
However, there are areas that toothbrushes cannot reach. The PZR (professional tooth cleaning) is important here, which can also cover the gum line and the spaces between the teeth and can prevent the colonization of bacteria that cause inflammation. The PZR must also be regularly supplemented by professional implant cleaning in the dental practice. In addition, attention must be paid to the dosed load on the implant during the healing phase.
Nicotine is a factor in perimplantitis that must be avoided at all costs. As with periodontitis, nicotine also conceals the first signs of inflammation in peri-implantitis, so that the affected person often visits the dentist treating him very late. Quitting the aftercare routine is a step in the right direction for your teeth and gums and overall health.
You can do that yourself
Peri-implantitis is a disease after implant placement, which can often be prevented by those affected and also improved by supporting the treatment in everyday life. In this context, it is important that measures ordered by the dentist must be followed. It is particularly important to give up smoking, as nicotine promotes peri-implantitis and can significantly delay its healing. Even full loading of the implant site by chewing hard food is only allowed if the dentist has allowed it. Alcohol is also a factor that can delay regeneration, so avoiding alcoholic beverages is also part of self-help against peri-implantitis.
Cleanliness and hygiene are among the most important measures with which peri-implantitis can be combated and also prevented from the outset. Many patients shy away from cleaning this area intensively because they do not want to irritate it further. But exactly the opposite is the case. The more carefully the area around the implant is cleaned, the easier it is to eliminate bacteria that can cause inflammation. During the professional implant cleaning that is recommended twice a year, the dentist also points out any mistakes in the cleaning technique and thus helps the patient to optimally organize the oral hygiene that is so important at home.