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Peri-implantitis - A disease of the implant bed

Unfortunately, there are also inflammatory diseases with implants, which can also often lead to the loss of one or more implants. The causes range from a lack of oral hygiene to smoking, diabetes and technical errors during implantation or in the dental laboratory.

Bacteria, biofilm and plaque can also be deposited on a dental implant or the denture on top of it (superstructure). This leads to permanent foci of inflammation and the onset of periimplatitis. The blood supply to the tissue is impaired, the body's defences can be weakened and the bone breaks down around the implant. Often the disease progresses completely without pain and is not noticed by the patient or is noticed too late. The inflammation of the gums is called mucositis by the dentist.

It is therefore very important to regularly remove the plaque yourself with dental floss or interdental brushes. The check-up appointments including professional tooth cleaning should also be kept in order to remove plaque completely. Risking periimplatitis is probably not an alternative, as surgical treatment is almost always necessary here.

However, there are also good treatment options, which are not carried out by every dental practice. Here, years of experience of the dentist are a key to success.

In any case, professional tooth cleaning and very good oral hygiene are incredibly important for the preservation of the teeth and also the inserted implants.

Smokers have a much poorer chance of success due to the toxins that enter the mouth, tissues and body with each puff.

In the case of peri-implantitis, it has proven effective to mechanically smooth and polish the implant surface and the transition to the gums at the crown. This way, paque and biofim adhere less easily to the metal surface.

Fine gaps at the transition to the implant are thus detected and can be closed to minimise the penetration of germs. Diabetes also reduces the healing of peri-implantitis. Often the metals form a chemical change on the surface due to germ colonisation. This can be improved by polishing and removing the oxide layer.

However, material is also removed here and a formation of gum pockets or tissue degradation then possibly leads to renewed and stronger colonisation. Unsightly and visible defects then expose the metal and implant and show aesthetic flaws.

Treatment options as a step-by-step plan for peri-implantitis:

A - Cleaning and disinfection with powder jet devices ( air-flow ), use of lasers, disinfecting rinses, administration of antibiotics.

B - Surgical treatment - removal of affected tissue - removal of dentures - curettage - immobilisation.

C - If treatment is successful, bone augmentation is often possible to replace tissue.

D - If this is not possible, the implant must be removed promptly to prevent further bone loss and to preserve the option of a new implantation with or without bone augmentation.

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