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Peri-implantitis

Peri-implant infections are pathological conditions surrounding dental implants. 

Mucositis refers to inflammation and ulceration in the soft tissues around an implant and is a reversible host response to periodontal pathogens. Peri-implantitis, the destructive inflammatory process affecting both soft and hard tissue surrounding a dental implant, is more severe and leads to bone loss1. 

The typical signs and symptoms of the diseases, as discussed in various consensus conferences, can be described as follows2-8.

Mucositis 

  • Bleeding on probing 
  • Redness and swelling of soft tissue 
  • No loss of supporting bone

Peri-implantitis 

  • Crater-like bone defect 
  • Bleeding and/or suppuration on probing 
  • No implant mobility
  • >4 mm peri-implant depth probing 

A reliable diagnosis of peri-implantitis requires the simultaneous presence of all above listed signs and symptoms. A single feature alone is not sufficient for the diagnosis.


Treatment of peri-implantitis

Peri-implantitis should be treated systematically. Bacterial plaque removal with surgical and/or non-surgical therapy is essential to prevent further progression and prepare the defect for regenerative procedures9. 

Guided bone regeneration with Geistlich Bio-Oss® and Geistlich Bio-Gide® regenerates the osseous defect after implant surface decontamination has been performed10.

References:

  1. Lang NP, et al.: Ann Periodontol 1997; 2(1): 343-56.
  2. Mombelli A, et al.: Clin Oral Implants Res 2012; 23 Suppl 6: 67-76.
  3. Lang NP, et al.: J Clin Periodontol 2011; 38 Suppl 11: 178-81.
  4. Lindhe J, et al.: J Clin Periodontol 2008; 35(8 Suppl): 282-85.
  5. Mombelli A: Criteria for success. Monitoring In: Proceedings of the first European Workshop on Periodontology, (eds.) N.P. Lang & T. Karring, pp. 317–325. London: Quintessence 1994.
  6. Mombelli A: Prevention and therapy of peri-implant infections. In: Proceedings of the 3rd European Workshop on Periodontology, (eds.) N.P. Lang, T. Karring & J. Lindhe, pp. 281–303. Berlin: Quintessenz Verlag 1999.
  7. Tomasi DP & Derks J: J Clin Periodontol 2012; 39 Suppl 12: 207-23.
  8. Zitzmann NU & Berglundh T: J Clin Periodontol 2008; 35(8 Suppl): 286-91.
  9. Schwarz F & Becker J: Peri-implant Infection: Etiology, Diagnosis and Treatment. Quintessence Publishing 2007.
  10. Schwarz F, et al.: J Clin Periodontol 2009; 36(9): 807-14.

     

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