Peri-implantitis: how to treat dental implant infection

When having dental implants, it is important for you to have follow-up dental examinations as well as hygiene visits to discover any early signs of peri-mucositis (the precursor to peri-implantitis) as at this stage you have much better prognosis for full recovery.

The disease peri-implantitis is a destructive inflammatory process, which affects the soft and hard tissues surrounding the implants. The gums around the implant should not be swollen, bleeding, producing pus, or reddened in appearance and if this is the case, it’s time to go back to your specialist.

Leading dentist Dr Shirin Parsno holds a special interest in implantology and peri-implantitis and here she explains the risk factors for developing the disease and how it is treated.
 

How can I tell if I have peri-implantitis?

Bleeding on probing is considered normal whilst tissues are healing shortly after implantation. If bleeding is present months or even years after placement, the inflammation needs to be examined by your dentist. Other warning signs include pus, the presence of a pocket around the implant and the recession of the gums. Any swelling and redness of the gums are referred to as erythema.
 

What are the risk factors for developing peri-implantitis?

Some risk factors include:

• Smoking
• Periodontitis
• Diabetes
• Poor plaque control
• Lack of regular dentist visits for check-ups

Some patients feel discomfort whilst brushing around their implants, or they are unable to access some areas for cleaning and are advised to speak to their dentist about this. Patients must carry out plaque removal regularly to prevent and treat peri-mucositis by brushing their teeth. Dentists must also deliver oral hygiene instructions to ensure that the patient is removing plaque sufficiently as well as removing their calculus (dental tartar).
 

What are the different treatment options for peri-implantitis?

The following are treatment options for peri-implantitis:
 
Mechanical debridement
This process removes calculus. It requires a special electronic tool that uses ultrasonic vibrations to break up the tartar and remove the plaque and food debris. Scaling tools are then used on the teeth and root surfaces for an optimal deep cleaning treatment. This process enables the dentist to check the gum line and see if the bone is healthy and that there is no periodontal disease.

Antiseptic treatment
This is performed in conjunction with mechanical debridement, using the application of chlorhexidine digluconate – which is a potent antiseptic. For the best results, the patient should use chlorhexidine as a daily rinse or as a gel, for 3-4 weeks. It is shown to significantly improve the mucosal condition in bleeding on probing and on probing pocket depth. A laser beam can also be used to disinfect the area.

Antibiotics
This approach aims to eliminate or significantly reduce the pathogens (bacteria) and is administered during the last 10 days of antiseptic treatment. It allows the peri-implant infection to be treated successfully and remain stable.

Surgical treatment
Surgical flap management is only considered if the infection is controlled successfully. This treatment is used to restore the bony support through guided bone regeneration or to reshape the peri-implant soft tissue. This also helps in comprehensive debridement and local decontamination of the affected implant. It is vital for the dentist to consider the aesthetic and morphological characteristics of the peri-implant lesion when considering surgical techniques.


If you need a routine check-up for your dental implants, then do not hesitate to book an appointment.