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Peri-Implant Mucositis and Peri-Implantitis (Gum Disease around Dental Implants)

Peri-Implant Mucositis and Peri-Implantitis (Gum Disease around Dental Implants) - What it is

​Peri-Implant Diseases


  • Peri-implant diseases are caused by bacteria build-up on the dental implant surface
  • This causes inflammation of the gums surrounding the implant. This is known as peri-implant mucositis

Plaque deposits around implants
  • If left untreated, mucositis can progress to a more severe condition called periimplantitis, where bone around the implant is lost. This condition is difficult to treat. Eventually, the implant becomes loose and has to be removed
An implant with extensive bone loss, which has to be removed

Who is at risk?

  • Patients with poor oral hygiene
  • Patients with gum disease (periodontitis)
  • Patients who do not attend regular dental check-ups
  • Patients who smoke

Peri-Implant Mucositis and Peri-Implantitis (Gum Disease around Dental Implants) - Symptoms

What are the symptoms?

  • Gums around the implant bleed easily
  • Gum swellings
  • Bad breath or a bad taste in your mouth
  • Loosening of the implant

Peri-Implant Mucositis and Peri-Implantitis (Gum Disease around Dental Implants) - How to prevent?

How can I prevent it?

  • Good oral hygiene at home is key to preventing periimplant diseases
  • Regular dental check-ups after the implant is placed, especially if you have a history of gum disease
    - Periodic X-rays will be taken to monitor bone levels around the implant
  • Quit smoking

Peri-Implant Mucositis and Peri-Implantitis (Gum Disease around Dental Implants) - Causes and Risk Factors

Peri-Implant Mucositis and Peri-Implantitis (Gum Disease around Dental Implants) - Diagnosis

Peri-Implant Mucositis and Peri-Implantitis (Gum Disease around Dental Implants) - Treatments

I have an implant diagnosed with peri-implant disease. What is the treatment?

For mild cases (peri-implant mucositis), self maintenance of good oral hygiene around your dental implant, as well as regular professional cleaning by your dentist/hygienist may be enough to control the disease

In severe cases where bone around the implant has been lost, additional gum surgery may be required. This may involve:    
- Bone grafting to reconstruct bone support which has been lost


Bone loss around an implant with a bony defect


Bone grafting within the defect

- Gum grafting to improve the quality of gums


Lack of good quality gum tissues around the bottom right back molar implants


After gum surgery, an increased width of good quality gum tissues is created around the implants

- Surgery to trim bone irregularities around the implant
- Implantoplasty, where threads of the implant are flattened


An implant receiving implantoplasty, with trimming of the surrounding bone to create a healthy bone architecture

- Adjustment or remake of the implant crowns


Before adjustment of the crowns


After adjustment of the crowns: more space to allow for insertion of interdental brushes to maintain oral hygiene at the area


An example of how an interdental brush is inserted between implants

In many cases, a combination of the above is needed. If the disease has progressed too far, the above treatment may be insufficient and removal of the implant may be necessary.
 

Peri-Implant Mucositis and Peri-Implantitis (Gum Disease around Dental Implants) - Preparing for surgery

Peri-Implant Mucositis and Peri-Implantitis (Gum Disease around Dental Implants) - Post-surgery care

Peri-Implant Mucositis and Peri-Implantitis (Gum Disease around Dental Implants) - Other Information

Frequently Asked Questions (FAQ)

1: What are the success rates for treatment of peri-implant diseases?

  • With treatment and regular supportive care, over 90% of implants in over 85% of affected patients still had their implants after 5 years

  • However, some implants may require retreatment, further therapies, or even implant removal[1]  

  • Preventing the disease is crucial, through correct oral hygiene techniques and regular professional cleaning of your teeth and implant(s)    

2: Can I just remove my old implant and put a new one in? 

  • In some cases, your dentist may advise removal of your implant

  • The old implant site must be allowed to heal, and your dentist will assess if it is suitable for a new implant after a few months

  • Very often, there will be insufficient bone for a new implant, and additional bone grafting will be required

  • In cases where bone loss is too severe for additional bone grafting, alternative methods of replacing teeth such as dentures or bridges may be considered 

[1] Roccuzzo, M., Layton, D. M., Roccuzzo, A., & Heitz-Mayfield, L. J. (2018). Clinical outcomes of periimplantitis treatment and supportive care: A systematic review. Clin Oral Implants Res, 29 Suppl 16, 331-350. doi:10.1111/clr.13287


The information provided is not intended as medical advice. Terms of use. Information provided by SingHealth

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