“Prevention is better than cure” is a famous saying, and it also forms the basis for the success of dental implants. While we spend a considerable amount of time on placing dental implants, we need to emphasize equally on their retention. Prevention of both hard and soft tissue defects around dental implants are most essential for the life of implants.

Peri-implantitis is one of the most frequent complications of dental implants which can lead to implant failures. Statistics say dental implants have a success rate of 82.9% after 16 years of follow-up, and 56% of dental implants face peri-implantitis.

Peri-implantitis can adversely affect the health of surrounding hard and soft tissues and disrupt osseointegration. Thus, it needs immediate attention to prevent implant failures. While mucositis is gingivitis of dental implants, peri-implantitis is periodontitis of dental implants. Like periodontitis, peri-implantitis causes bone loss, pocket formation, and purulence around implants.

Research says prevention of peri-implantitis is the best solution, as treatment of peri-implantitis does not always guarantee successful osseointegration.

Here’s what we can do to prevent peri-implantitis:

Timely follow-ups
Timely follow-ups are mandatory. They help to assess the current status and also assist in the early identification of issues which can be detrimental to the life of implants. Immediate action can extend the life of implants.

Oral hygiene
Nothing can compensate for good oral hygiene.

Rinsing the mouth each time after having food
Having a healthy diet which is minimal on refined foods such as sugar and refined flour
Diet rich in fibrous foods such as fruits and vegetables
Brushing twice a day and flossing every day
are helpful.

Elimination of risk factors such as smoking,systemic diseases such as diabetes, and periodontitis is essential.
Tobacco and tobacco dosage have a direct impact on peri-implantitis, and implant failure.
A better glycemic control implies better oral health and vice versa.
History of periodontitis increases the risk of peri-implantitis by six times!
Treatment for peri-implantitis

If there is mucositis or moderate peri-implantitis, we can treat them with conservative measures such as:

Manual ablations, mechanical cleaning of implants with plastic or titanium curettes with softer tips and air polishing
Photodynamic therapy
Laser-supported systems
Antiseptic rinses
Antibiotics: local and systemic
These measures can help in regaining osseointegration.

For advanced peri-implantitis, resecting peri-implant lesions via osteotomy, osteoplasty, and bacterial decontamination, help to regain osseointegration. Bone grafting with autologous, allogenic, and xenogenic bone replacement materials are also useful.

Though peri-implantitis is a serious issue, we have to be cautious while diagnosing. Bleeding on probing, deep probing depths, and bone loss may also mean a deep insertion of implants and not peri-implantitis!

Reference:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4164121/
https://www.ncbi.nlm.nih.gov/pubmed/20636731
https://www.ncbi.nlm.nih.gov/pubmed/23198360
https://www.ncbi.nlm.nih.gov/pubmed/23726497
https://www.efp.org/aboutefp/prizes-and-awards/pastwinners/postgrad/2012/1st-prize-12-g-charalampakis.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228943/
https://onlinelibrary.wiley.com/doi/full/10.1002/JPER.16-0810
https://dentistchannel.online/2018/10/30/real-story-behind-implant-genesis-dr-jiju-john/
https://dentistchannel.online/2018/11/14/zygomatic-implants-noris-medicals/