by Jonathan Richter, DDS, FAGD
It’s almost universal knowledge that teeth often succumb to the ravages of dental disease, such as 
tooth decay, gum disease or trauma. But did you know that dental implants, tooth-root replacements upon which new crowns are placed, are also prone to disease of the tissues that attach to and surround them? In fact, inflammation and infection of the surrounding tissues that support implants is perhaps the greatest cause of concern today regarding implant failure. It is generally referred to as peri-implantitis. While prevalence is currently unavailable, it would appear that peri-implantitis occurs in about one out of every 10 implants.
The first phase of peri-implantitis is a condition in which the gum tissues surrounding the implant become inflamed or infected. This most commonly results from (bacterial) biofilm but also can result from excess dental cement that is not completely removed. If inflammation/infection is limited to the gum tissues, then improving oral hygiene and cleaning to remove dental biofilm and any excess cement can generally manage it.
Deeper-seated inflammation/infection extending into the bone destroys the connection to the implant, the all-important osseointegration. This is much more problematic; it undermines the support for the implant, and hence the tooth root and crown it replaces. This is what is referred to or diagnosed as peri-implantitis, and often has the usual signs of inflammation, such as redness, swelling, bleeding and pus formation. In more severe cases, bone loss can be rapid and, ultimately, the implant can loosen and be lost.
Don’t get too worried, dental implants do have the highest success rate of any tooth-replacement system. Peri-implantitis can be treated successfully if caught early. It requires control of the inflammation/infection with local cleaning or antibiotics. In more advanced cases, attempts at surgical repair may be necessary to regain attachment and bone. The biggest problem here is decontaminating the exposed implant surfaces, which are microscopically roughened by the manufacturer to aid attachment to the bone. This creates hiding places for bacteria. If an implant is lost due to peri-implantitis, every effort should be made to preserve the surrounding bone and replace the implant.
Maintenance is your best protection and pays great dividends in avoiding implant failure. Once the implants are placed, the ball is largely in your court. It’s crucial to maintain a good oral hygiene routine. Make sure you have regular professional dental checkups and cleanings to help keep the tissues around your implants healthy.
Source: Jonathan Richter, DDS, FAGD, of Cardiodontal (310 E. Shore Rd., Ste. 101, Great Neck). For more information or to schedule an appointment, call 516-282-0310 or visit Cardiodontal.com.
