Peri-implantitis factors, diagnosis, symptoms and treatment

Peri-implantitis has been a matter of debate since long as to whether it is a disease or a complication of dental implants.

According to the joint meeting conducted jointly by the European Federation of Periodontology (EFP) and the American Academy of Periodontology (AAP) in 2017, a working definition of peri-implantitis was suggested as follows:

“[A] plaque‐associated pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri‐implant mucosa and subsequent progressive loss of supporting bone.”

• Oral hygiene
• Smoking and alcohol consumption
• Existing or previous periodontitis
• Diabetes mellitus
• Some medications and radiation therapy
• Systemic conditions like cardiovascular disease

1. Compromised Immune System: Patients suffering from a chronic disease that affects the whole body such as diabetes is at a higher risk to peri-implantitis. If you have diabetes or another systemic illness, we will thoroughly examine and plan the implants accordingly. At Dr. Rajat Sachdeva’s clinic, we have a thorough understanding of how these diseases affect peri-implantitis, and we can adjust our treatment accordingly. We also insist on taking a thorough case history where the patients can tell us about any previous infections of the mouth they had, as it can put them at a greater risk of peri-implantitis.
2. Insufficient Dental Care: Peri-implantitis is caused primarily by the bacteria and food materials that slowly accumulate around dental implants and gum lines. Careful and consistent dental care is needed in order to minimize and eliminate harmful pathogens, which are found in plaque and tartar. As with most other dental conditions, peri-implantitis can be made worse by smoking, alcohol and drug use. We at Dr. Rajat Sachdeva’s clinic make sure to educate our patients enough about the importance of good oral hygiene.
3. Parafunctional Habits: Parafunctional habits are generally involuntary habits that you may develop. They can be due to malformation of part of your body or a nervous tick. They can even occur unconsciously during sleep. Habits like grinding your teeth in your sleep (bruxism), poorly positioning your teeth when your jaw is closed, nail-biting and others. These habits can also adversely affect the health of your periodontium and may cause peri-implantitis, in case of implants.

It is absolutely necessary to probe around each implant at 6 points and, using a periodontal probe, to perform a detailed inspection, and, if necessary, additional radiographic examination. While probing, we look out for red flags like increased probing depth, as well as presence of bleeding on probing and suppuration (pus discharge). Suppuration can also be detected by means of palpation.

The main criteria for the distinction between healthy and inflammatory mucosa is bleeding on probing.

The main criteria for the distinction between peri-mucositis and peri-implantitis is deterioration in the bone supporting the dental implant.

If you have an implant placed and are curious to know about its health, the following signs suggest that you are doing absolutely fine. However, these signs should be demonstrated by your dentist.

• Absence of clinical signs of inflammation
• Absence of bleeding and/or suppuration on gentle probing
• No increase in probing depth compared to previous examinations
• Absence of bone loss beyond crestal bone level changes resulting from initial bone remodeling

1. The first and the foremost symptom of periimplantitis is inflammation which can present as redness, swelling, and pain of the gum tissue around the implants.
2. The pocket around the implant becomes more evident during probing leading to receding gum line.
3. The actual implant might get exposed and be shown.
4. Loosening of the implant.
5. If suppuration is present, it will present as pus discharge causing an unpleasant sensation in the mouth of the patient.
6. Bleeding on mild probing is seen.
7. Lymph nodes near the jaws or neck will become tender and palpable.

Dr. Rajat Sachdeva strongly recommends his patients to schedule an appointment if they face any pain or discomfort around the dental implants and it is affecting their daily activities. Pain or sensitivity while chewing, drinking, exercising, moving your head into different positions, headaches, soreness or stiffness in the jaw is not healthy and indicates a problem and needs to be looked at by us as soon as possible.

It is important to remember that while these more severe symptoms are real risks, they only happen when peri-implantitis is left untreated for significant amounts of time. When caught early and provided adequate supervision from a competent periodontist, peri-implantitis can be treated before it ever causes undue discomfort or embarrassment.

The first symptom that the patient complains of is peri-implant mucositis, which is usually diagnosed during regular oral hygiene checkups. It is nothing but the inflammation of the mucosa surrounding the implant. Other signs might include: bleeding, redness, pain, pus.

These symptoms alone, however, are not enough to diagnose peri-implantitis in an implant patient. We usually study a series of radiographs taken over several follow-up appointments to determine whether an implant site is displaying progressive marginal bone loss.

1. The first and the foremost symptom of periimplantitis is inflammation which can present as redness, swelling, and pain of the gum tissue around the implants.
2. The pocket around the implant becomes more evident during probing leading to receding gum line.
3. The actual implant might get exposed and be shown.
4. Loosening of the implant.
5. If suppuration is present, it will present as pus discharge causing an unpleasant sensation in the mouth of the patient.
6. Bleeding on mild probing is seen.
7. Lymph nodes near the jaws or neck will become tender and palpable.

Dr. Rajat Sachdeva strongly recommends his patients to schedule an appointment if they face any pain or discomfort around the dental implants and it is affecting their daily activities. Pain or sensitivity while chewing, drinking, exercising, moving your head into different positions, headaches, soreness or stiffness in the jaw is not healthy and indicates a problem and needs to be looked at by us as soon as possible.

It is important to remember that while these more severe symptoms are real risks, they only happen when peri-implantitis is left untreated for significant amounts of time. When caught early and provided adequate supervision from a competent periodontist, peri-implantitis can be treated before it ever causes undue discomfort or embarrassment.

The first symptom that the patient complains of is peri-implant mucositis, which is usually diagnosed during regular oral hygiene checkups. It is nothing but the inflammation of the mucosa surrounding the implant. Other signs might include: bleeding, redness, pain, pus.

These symptoms alone, however, are not enough to diagnose peri-implantitis in an implant patient. We usually study a series of radiographs taken over several follow-up appointments to determine whether an implant site is displaying progressive marginal bone loss.

We at Dr. Rajat Sachdeva’s dental institute are committed to providing our patients with best and latest technology to improve and maintain their dental health.

Dr. Rajat Sachdeva is one of the best oral and maxillofacial surgeons around in Delhi. He has an experience of more than 17 years in this field. He has a keen eye for detail and strives to provide a high quality, ethical treatment to his patients. He has a warm personality and understands the impact of a good smile on patient’s wellbeing. We are also proud to announce that our clinic has invested heavily in acquiring new and latest surgical technology ensuring that our patients get the best treatment possible.

Our endeavor is to make the best quality dentistry available to all patients at affordable prices. All the treatments available at our practice is cost-effective with high standards.

We have an excellent follow-up team wherein we maintain detailed records of our patients and reach out to them regularly even after the treatment is over.

We are a 24*7 team who works round the clock to provide services to our patients.

To know more about implants, do visit us for a consultation today. We will be happy to discuss it with you.