Peri-implantitis is a condition similar to periodontal disease seen around teeth. The diagnosis is fundamentally based on the presence of mucositis (see peri-implant mucositis) but with an underlying infection (pus) and bone loss around the implant itself which is evident on x-rays (see below). This bone loss is similar to the bone loss seen around teeth. Other contributory factors are smoking, poor oral hygiene and systemic conditions such as diabetes.
The treatment for peri-implantitis is initially conservative as with peri-implant mucositis, i.e. irrigation under the gum with antimicrobial agents but also with the topical application of antibiotic gels below the gum and into the pockets that form deeper down into the bone. This procedure can often be achieved without recourse to any anaesthetic, but for the more tender sites a simple local anaesthetic is all that is required.
If the more conservative treatment fails to address the infection or if the disease is already too extensive on presentation then surgical decontamination may be recommended. This will involve lifting the gum to remove the inflamed and infected tissue from around the implant/s and to decontaminate the surface of the implant/s which will have now become compromised. It may be necessary to undertake some form of bone grafting to repair any resultant defects. Such surgery is carried out under local anaesthetic and if required our anaesthetist can be employed to give intravenous sedation so that the experience is more comfortably accommodated and easily forgotten due to the amnesic properties of sedatives.
In the most extreme cases it may be necessary for implants to be removed. Clearly this is very upsetting, and we take every care to explain the reasons why and to support you through the treatment. However we can often repair the damage and subsequently replace the implant/s for new, ultimately restoring you to full dental health. You would then remain on regular recalls to ensure that the disease is kept at bay and does not affect your new implant/s.
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