Peri-implantitis is inflammation around an implant that leads to bone loss. Its early stage is reversible, which is why regular reviews matter so much.
Peri-implantitis is inflammation of the tissues around an implant that has progressed into bone loss. Think of it as the implant equivalent of gum disease. Crucially, it has a reversible early stage, and caught there it can be stopped before any bone is lost.
Two stages
The first is peri-implant mucositis: inflammation confined to soft tissue, with redness, swelling and bleeding on brushing, but no bone involvement. It is reversible with proper cleaning and professional care. If inflammation persists it reaches the bone, and lost bone does not return on its own.
Signs to notice
- Bleeding when brushing or using interdental brushes
- Redness and swelling around the implant
- Bad odour or taste from the gum
- Recession, making the restoration look longer
- Tenderness on pressure
- A sense of looseness in advanced cases
Pain is usually a late finding, so waiting for symptoms is a poor strategy. Scheduled reviews find it far earlier.
Why it develops
The root cause is bacterial plaque that is not removed. Contributing factors include inadequate hygiene, smoking, a history of gum disease, uncontrolled diabetes, irregular reviews and restorations that are hard to clean around.
How it is diagnosed
Pocket depths around the implant are measured, bleeding is assessed and bone level is compared on radiographs. The film taken when the prosthesis was delivered is valuable as a baseline for exactly this comparison in later years.
Treatment
Early on, treatment means cleaning the implant surface with appropriate instruments, reviewing the design of the restoration and reworking the patient's cleaning routine. Once bone is lost, surgical access and sometimes regenerative procedures are needed. Where natural teeth are affected too, gum treatment runs as part of the same programme.
Prevention
- Brushing twice daily with a soft brush
- Interdental brushes sized for the implant sites
- A water flosser where recommended
- Reviews every six months, more often if at risk
- Keeping professional cleaning appointments
- Stopping or reducing smoking
- Keeping conditions such as diabetes controlled
The role of design
A restoration that is difficult to clean encourages plaque no matter how diligent the patient. Access for cleaning is therefore designed in from the start, and your dentist may remove the prosthesis at a review to inspect beneath it. Good outcomes are a shared effort that continues long after implant treatment ends. Our Muratpasa clinic is open twenty-four hours a day, seven days a week.
