Peri-implantitis – a periodontitis on the implant?

Implants are particularly attractive as a dental prosthesis because they are visually and functionally indistinguishable from natural teeth. Unfortunately, even years after successful implantation, so-called peri-implantitis can occur, a disease which can end  with the loss of the implant.

development of peri-implantitis

In Germany, more than 1 million dental implants are placed each year. Often this is done as a replacement for teeth that have been lost due to periodontal disease. However, an inflammation at the implant can occur even a long time after successful healing. This so-called peri-implantitis has many features in common with periodontitis. It is also a multifactorial disease triggered by several risk factors, especially by the presence of certain bacteria. However, the peri-implant tissue has special structures that allow the bacteria to progress rapidly into deeper layers.

Development of peri-implantitis

A peri-implant disease begins when certain bacteria penetrate into the gap between implant and gum (e.g. due to ineffective oral hygiene) and multiply there. The reaction of the immune system against the bacteria and their metabolites produces an inflammation that can progressively destroy the tissue surrounding the implant. If the inflammation has not yet reached the jaw bone, it is called a mucositis. This early stage of the disease is completely curable through a dentist’s treatment and optimal oral hygiene.

Early therapy is important

However, if the infection has already spread to the jawbone, the damage can not be reversed. At this stage the disease is called peri-implantitis. Now the major goal of dental treatment is to stop the inflammation and to prevent further tissue and bone breakdown. Therefore, it is particularly important to detect and treat the infection as early as possible. Such peri-implantitis can occur even years after successful healing of the implant and without treatment often leads to loss of the implant.

Risk factors

The most important risk factor for peri-implantitis is the presence of periodontitis. However, there are a few other common risk factors that increase the risk of developing peri-implantitis. This includes e.g. a genetic predisposition, smoking, diabetes mellitus, stress or lack of oral hygiene. These coincide with the risk factors for periodontitis and are based on the same mechanisms. In addition to these similarities, there are also differences between periodontitis and peri-implantitis.