Peri-Implantitis

Peri-implantitis: Diagnostic Tests

The diagnosis of peri-implantitis is usually made on the basis of the patient’s medical history, clinical course and physical examination. Further medical device diagnostics may be required for differential diagnosis. Obligatory medical device diagnostics Radiographs Especially dental film recording in parallel technique Panoramic slice image (synonyms: orthopantomogram, OPG) Cave: lower resolution, eccentric imaging in premolar … Peri-implantitis: Diagnostic Tests

Peri-implantitis: Medical History

The anamnesis (medical history) represents an important component in the diagnosis of periimplantitis, in addition to the diagnostic findings. Social history Indications of psychosocial stress [stress/bruxism as a risk factor]. Current medical history / systemic history (somatic and psychological complaints). What complaints do you have? Where are the complaints localized? Do you observe any swelling? … Peri-implantitis: Medical History

Peri-implantitis: Or something else? Differential Diagnosis

Infectious and parasitic diseases (A00-B99). Peri-implant mucositis (inflammation of the oral mucosa). Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93). Gingival retraction (receding gums). Gingival hyperplasia (gum proliferation). Disease of the gingiva (gums) and edentulous alveolar ridge (tooth-bearing bone portion), unspecified. Mucosal hyperplasia (oral mucosal proliferation). Ostitis (synonym: osteitis; bone inflammation). Neoplasms – tumor … Peri-implantitis: Or something else? Differential Diagnosis

Peri-implantitis: Secondary Diseases

The most important diseases or complications that may be contributed to by peri-implantitis are: Respiratory system (J00-J99) Sinusitis maxillaris (maxillary sinusitis). Infectious and parasitic diseases (A00-B99). Scattering of pathogenic (disease-causing) bacteria in the blood and lymphatic circulation. Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93). Abscess formation (formation of a pus cavity). Chronic pain … Peri-implantitis: Secondary Diseases

Peri-implantitis: Classification

Defect classification according to Schwarz et al. Class Description I Intraosseous defects Ia Vestibular (oral vestibule) or oral dehiscence defects (defects due to divergence of associated tissue structures) Ib Vestibular or oral dehiscence defects with additional semicircular (“semicircular”) components Ic Vestibular or oral dehiscence defects with additional circular bone loss Id Circular bone resorption with … Peri-implantitis: Classification

Peri-implantitis: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic and therapeutic steps. Intraoral examination Mucosal findings [gingivitis (inflammation of the gums) Periodontitis (inflammation of the periodontium)] Foetor ex ore (bad breath) – [possibly with putrid (“purulent”) exudate / secretion] Oral hygiene Dental findings (general dental findings). Biofilm (plaque, bacterial plaque) on tooth and … Peri-implantitis: Examination

Peri-implantitis: Lab Test

The diagnosis of peri-implantitis is usually made only on the basis of the patient’s medical history and clinical examination as well as radiographs. To confirm the tentative diagnosis when there is uncertainty in the diagnosis or periimplantitis is difficult to treat – 2nd order laboratory parameters: Microbiological examinations – identification of lead germs for periodontal … Peri-implantitis: Lab Test

Peri-implantitis: Drug Therapy

Therapy goals Healing of an infection Targeted reduction/elimination of pathogenic biofilm (plaque, bacterial plaque). Support of mechanical cleaning processes Therapy recommendations No general therapy scheme available Local antibiosis (antibiotic therapy) as adjunctive therapy to mechanical debridement (wound toilet, i.e., removal of necrotic (dead) tissue) Use of antiseptics (chemical substances used to prevent wound infection; e.g., … Peri-implantitis: Drug Therapy

Peri-implantitis: Surgical Therapy

Dental surgery/oral and maxillofacial surgery. Therapeutic Objectives: Reduction of peri-implant (“around the implant”) pockets, improvement of cleanability, prevention of explantation (surgical removal of the implant). Exposure of the defect, subsequently. Mechanical debridement (wound toilet, i.e., removal of necrotic (dead) tissue). Cleaning of implant surfaces with special curettes and brushes (plastic, titanium). Decontamination (removal of one … Peri-implantitis: Surgical Therapy

Peri-implantitis: Prevention

Prevention and prophylaxis of peri-implantitis include assessing the individual risk of disease. For this purpose, the data collected in the medical history and findings are used. For prevention, attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Hydration Consumption of stimulants Tobacco (smoking) Oral hygiene Insufficient Not adapted to the clinical … Peri-implantitis: Prevention

Peri-implantitis: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate peri-implantitis: Pathognomonic (indicative of disease). Implant loosening Main symptoms Gingival condition (condition of the gums, which are part of the oral mucosa). Redness Swelling Gum bleeding – spontaneous or on probing If necessary, implant loosening Putrid (“purulent”) exudate (fluid secretion), if applicable. Foetor ex ore (bad breath), if … Peri-implantitis: Symptoms, Complaints, Signs

Peri-implantitis: Causes

Pathogenesis (development of disease) Peri-implantitis is a progressive inflammation of the bony bearing of a dental implant with peri-implant bone loss. Reversible inflammation of the soft tissue only is peri-implant mucositis (inflammation of the oral mucosa). The disease is caused by mixed anaerobic germs. Periodontopathogenic germs (germs that cause disease in the periodontium) can be … Peri-implantitis: Causes