Implants may loosen months or years after being placed. It occurs in only a low percentage of patients. When this happens, an infection called peri-implantitis may develop and be the reason an implant becomes loose or “unseats.”
Dental implants are essentially artificial teeth that replace the root part of natural teeth when missing or failing. They give you a strong foundation for a fixed prosthesis crafted to blend in with your natural teeth. Typically, you can avoid peri-implantitis following your implant placement procedure by adhering to your dentist’s follow-up dental implant care instructions.
A patient with peri-implantitis has gum inflammation around a dental implant’s soft tissue and typically has deterioration in the bone supporting the implant. It is a site-specific infectious disease that creates an inflammatory soft tissue issues and bone loss around an osseointegrated implant in function.
According to the bacterial theory, peri-implantitis is best defined as a chronic inflammatory condition associated with a microbial challenge.  This definition highlights the need for oral cleanliness and infection control following the procedure.
It is a multi-factorial disease; peri-implant mucositis is classified when inflammation is found only around the soft tissues adjacent to the dental implant, with no evidence of bone loss.
Awareness and education are important to prevent the onset and development of peri-implantitis. There are a number of factors that can impact oral implant success. You can avoid potential risks by understanding what they are and how to mitigate issues.
Every individual’s oral health is unique. Your long-term attention to dental care and visits impacts your overall health. This is why making the initial decision to enlist a dental implant service should be carefully assessed by a skilled dentist who knows your history and desired smile design goals.
The disease affects people differently, and different implant materials are used for the procedure at variable rates. Several health factors may play into the pros and cons of a dental implant procedure for you. Despite its predominantly bacterial etiology, varying factors may contribute to an increased risk of peri-implantitis.
Let’s look at each indicator more in-depth.
1. Red and swelling gums: A key common symptom of peri-implantitis after dental implant placement is redness, swelling, or tenderness near the implant site. This may cause minor discomfort – which is actually a helpful indicator that you should contact your dentist immediately.
2. Wobbly dental implant: If the dental implant moves or feels loose, it should be checked out to see whether it is integrating well with your jawbone due to peri-implantitis.
3. Bleeding gums: Be observant during your daily oral health cleaning routine to note if your gums are bleeding. This could signal a peri-implantitis issue if it occurs when you are brushing or flossing near your implant area.
4. Signs of infection: If a substance, like pus or other infection indicators around the dental implant, is visible, this clearly indicates a potential peri-implantitis issue.
5. Decreasing jawbone density: A loss in jawbone density surrounding your dental implant strongly indicates peri-implantitis. A dental implant is deemed successful if there is only 1.5–1.8 mm bone loss during the year after the procedure and not more than 0.2 mm annually.
6. Odd breath odor or taste: If someone near you mentions that you have odd or bad breath, note it. There is typically a reason for chronic bad breath – especially after this dental procedure. The same is true if you experience a persistent bad taste in your mouth afterward. It is worth checking out if it’s an indicator of a bacterial infection associated with peri-implantitis.
If you notice any of the above peri-implantitis symptoms, you cannot make a diagnosis on your own. Your dentist will answer the question if you are facing peri-implantitis disease. Which of the above factors could be the sole or major cause of your peri-implantitis (if you have it) needs professional assessment. One or more factors may merely be an additional factor contributing to the aggravation of the disease.
Your best prevention method is to be proactive and notice possible signials of complications.
The primary way to prevent complications is to avoid bacteria that can colonize around the implant abutment surface. If left untreated, it potentially affects the bone level around the implant.
Similar to gum disease, peri-implantitis is an oral health condition that continues to escalate without treatment. Do not count on it simply “going away.” To avoid more pain and further complication risks, take action immediately. Essentially, per-implantitis cannot disappear on its own. The disease is not curable; it can only be managed. And if it’s not managed, it will worsen.
Peri-implantitis tissue has extracellular matrix antibodies. The disease progression rate is more rapid and generates a faster and more severe loss of bone compared with periodontal disease. Maintaining overall excellent health will always be a plus and help your body recover. A nonlinear type of progressive bone destruction takes place over time in peri-implantitis.
How rapidly your peri-implantitis worsens depends, in part, on the differences in microorganisms at the implant sites, your body’s defense mechanism, and the absence of a periodontal ligament. A CBCT digital scan helps with diagnosis and treatment.
As well as the symptoms mentioned above that you may notice, your dentist will look for the following:
Peri-implantitis surgical treatments are available. First, we determine an appropriate management strategy, including local and systemic factors. Our dental office provides long-term supportive services and at-home instructions for peri-implant diseases. Our chief goals are infection control, preventing disease progression, and restoring lost bone.
Oral laser treatment often provides a short-term decrease in periodontal pocket depth; additionally, air powder abrasives are effective to clean a previously contaminated implant surface. Surgical elimination of a pocket, and bone recontouring are also effective for treating peri-implantitis.
At Woodbury, MN’s Montgomery Dental Care, we ensure a top-level professional process through all procedures and follow-up visits from your first evaluation. Our passion is to offer you the best dentist’s skills, knowledge, modern dental implant technology, and materials available today. The following quote underscores the importance of your specialist’s skill level and experience.
“Bone-level implant designs, combined with convex restorations at an angle exceeding 30°, significantly augment the risk of peri-implantitis.
Nevertheless, a systematic review evaluating earlier systematic analyses favored platform switching for peri-implant bone preservation. This could be due to the relocation of the microgap between the implant and the abutment. This microgap is wide enough to allow for bacterial colonization, and its horizontal offset away from the bone is believed to reduce the risk of peri-implant inflammation. Platform switching has also been supported by a recent clinical study that showed a significantly reduced probability of developing peri-implantitis. – A Comprehensive Review of Peri-implantitis Risk Factors
Dena Hashim’s July 27, 2020 article also suggests platform switching to reduce peri-implant bone loss.
Successful restoration dentistry is always a partnership between you and your dentist. The observant patient who notices any of the above symptoms following an implant placement has the best chance of saving the dental implant.
Peri-implantitis is rare. Our patient success rate is exceptional; view of gallery of dental implant cases to see for yourself.
Dr. Marc L. Montgomery trains fellow dentists and helps you learn if peri-implantitis is a concern after getting your dental implants. Call our Woodbury, MN office for a dental implant specialist’s diagnosis to determine if you have peri-implantitis.
 Alberto Monje, et al., Understanding Peri-Implantitis as a Plaque-Associated and Site-Specific Entity: On the Local Predisposing Factors, Feb 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6406659/
My entire family has been with Marc for more than 4 years. We have been so fortunate to have found him! He delivers superior results and is always eager to help me find a solution to my dental concerns when it comes to my bite and alignment. Even my children look forward to their dental visits, which is the exact opposite of me as a child! I would absolutely hands down recommend Montgomery Dental!