Topic:
Periodiabetes

Peri-implantitis is a condition that affects the tissues surrounding dental implants.

It is caused by the accumulation of plaque biofilm and is characterised by inflammation of the peri-implant tissues and a progressive loss of the supporting bone around the implant.

Before peri-implantitis develops, a milder form of inflammation known as peri-implant mucositis may occur.

Peri-implant mucositis vs Peri-implantitis

  • Peri-implant mucositis involves inflammation of the soft tissues around an implant without any bone loss.
  • Peri-implantitis includes both inflammation and bone loss around the implant.

How is peri-implantitis diagnosed?

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Research shows that peri-implant mucositis affects around 43-47% of people with dental implants, while peri-implantitis affects approximately 20-22%.

Peri-implantitis shares some similarities with periodontitis (gum disease), but it is important to understand that peri-implantitis can progress more rapidly and in an unpredictable, non-linear way. This means that bone loss can occur suddenly and at varying rates.

What causes peri-implantitis?

There are two primary causes:

  • Poor plaque control
  • Irregular attendance at maintenance (supportive peri-implant care) appointments

 Other risk factors:

  • A history of severe gum disease (periodontitis)
  • Smoking
  • Diabetes
  • Implants that are not placed in the optimal position
  • Poorly designed implant restorations
  • Lack of keratinised gum tissue around the implant

By maintaining good oral hygiene and attending regular maintenance appointments, the risk of developing peri-implantitis can be significantly reduced.

References:

Lee CT, Huang YW, Zhu L, Weltman R. Prevalences of peri-implantitis and peri-implant mucositis: systematic review and meta-analysis. J Dent. 2017 Jul;62:1-12. doi: 10.1016/j.jdent.2017.04.011. Epub 2017 May 3. PMID: 28478213.
Derks J, Tomasi C. Peri-implant health and disease. A systematic review of current epidemiology. J Clin Periodontol. 2015 Apr;42 Suppl 16:S158-71. doi: 10.1111/jcpe.12334. PMID: 25495683.
Berglundh T, Armitage G, Araujo MG, Avila-Ortiz G, Blanco J, Camargo PM, Chen S, Cochran D, Derks J, Figuero E, Hämmerle CHF, Heitz-Mayfield LJA, Huynh-Ba G, Iacono V, Koo KT, Lambert F, McCauley L, Quirynen M, Renvert S, Salvi GE, Schwarz F, Tarnow D, Tomasi C, Wang HL, Zitzmann N. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol. 2018 Jun;45 Suppl 20:S286-S291. doi: 10.1111/jcpe.12957. PMID: 29926491.
Berglundh T, Mombelli A, Schwarz F, Derks J. Etiology, pathogenesis and treatment of peri-implantitis: A European perspective. Periodontol 2000. 2024 Feb 2. doi: 10.1111/prd.12549. Epub ahead of print. PMID: 38305506.
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Written By : Dr Varkha Rattu

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