Understanding Risks, Prevention, and Maintenance for Peri-Implant Disease
Peri-implant diseases, including peri-implant mucositis and peri-implantitis, are inflammatory conditions caused by plaque biofilm that can lead to significant bone loss if left untreated. With no standardized treatment guidelines, prevention through peri-implant maintenance therapy is essential, as noncompliant patients face a threefold risk of developing peri-implantitis.
Peri-implant diseases are inflammatory conditions involving the peri-implant tissue caused by a plaque biofilm. The two types are peri-implant mucositis and peri-implantitis.
Peri-implant mucositis is the presence of inflammation confined to the peri-implant soft tissue with no signs of progressive bone loss following the initial bone remodeling.1 Clinical signs of inflammation include bleeding on probing, erythema, edema and/or suppuration, and an increase in probing depths.1,2
If peri-implant mucositis is left untreated, it will progress to peri-implantitis.
Peri-implantitis is when inflammation has progressed to the peri-implant soft tissue with progressive bone loss.3,4 The criteria for peri-implantitis are probing depths ≥ 6 mm in the presence of inflammation with ≥ 3 mm of bone loss.
Currently, no standard therapeutic guidelines for treating peri-implantitis are available. As a result, preventing peri-implant disease is critical with peri-implant maintenance therapy serving as a vital component. Patients who are noncompliant with peri-implant maintenance therapy are three times more likely to develop peri-implantitis compared to compliant patients.5 Peri-implant maintenance therapy allows for early identification and management of complications.
References
- Heitz-Mayfield LJA, Salvi GE. Peri-implant mucositis. J Clin Periodontol. 2018;45:237-245.
- Berglundh T, Armitage G, Araujo MG, et al. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions. J Clin Periodontol. 2018;45:286-291.
- Herrera D, Berglundh T, Schwarz F, et al. Prevention and treatment of peri-implant diseases — the EFP S3 level clinical practice guideline. J Clin Periodontol. 2023;50:4-76.
- Schwarz F, Derks J, Monje A, Wang HL. Peri-implantitis. J Periodontol. 2018;89:267-290.
- Monje A, Aranda L, Diaz KT, et al. Impact of maintenance therapy for the prevention of peri-implant diseases: a systematic review and meta-analysis. J Dent Res. 2016;95:372-379.
This information originally appeared in Casarez-Quintana AR. Enhancing long-term success with screw-retained implants. Decisions in Dentistry. 2024;10(5):10-14.
