Peri-implantitis is an inflammatory process affecting the soft and hard tissues surrounding a dental implant. This condition is associated with loss of supporting bone, bleeding on probing, and occasionally suppuration. Peri-implantitis can be influenced by three factors:
- Patient-related factors including systemic diseases (e.g, diabetes, osteoporosis) and prior dental history (periodontitis)
- Social factors such as inadequate oral hygiene, smoking, and drug abuse
- Parafunctional habits (bruxism and malocclusion).
In addition to the above, faulty restorations, cement left following restoration delivery, and/or loose components can also play a significant role in the development of peri-implantitis. There are several methods of treating peri-implantitis which include:
- Conservative debridement with or without systemic antibiotic treatment
- Surgical debridement (involves retracting the gum to gain access to the implant surface in order to detoxify it, and where feasible
- Surgical debridement with guided bone regeneration (GBR) for reparation of bony and soft-tissue defects.
Because there are biologic differences between teeth and implants, the progression of infection around implants is different than natural teeth. The inflammatory cells around implants extend more when compared to the corresponding lesion on natural teeth. In addition, the tissues around implants are more susceptible to plaque-associated infections that spread into the alveolar bone.
Systemic administration of antibiotics is sometimes used in the treatment of peri-implantitis, resulting in a reduction of inflammation, however, the success of antibiotic therapy as sole therapy has limited efficacy due to bacterial recolonization of the implant surface.