Inflammation of the dental implant is a so-called “peri-implantitis”, in which 2 different types can be described. On the one hand there is the so-called peri-implant mucositis, in which the inflammation is limited to the mucosa surrounding the implant. On the other hand, peri-implantitis is described, which has spread to the bony implant site. Peri-implantitis is always preceded by peri-implant mucositis. In the worst case, periimplantitis can lead to implant loss and therefore requires adequate treatment at an early stage.
Causes/Risk factors
In periimplantitis, a distinction is made between local and systemic risk factors. Local risk factors are causes that affect the implant itself. Systemic risk factors, however, are causes that affect the patient.
Generally speaking, a dental implant is in close contact with the intraoral environment and therefore with the bacteria in that environment. A firm, connective tissue, peri-implant seal to the oral cavity should be ensured to prevent bacterial colonization in this area. In the area where the implant breaks through the gum or the mucous membrane, a so-called sulcus is formed.
This is where plaque and bacteria accumulate and, if the implant is not cleaned properly or if certain risk factors are present, this can lead to inflammation and, in the worst case, to loss of the implant. The main cause is the absence of the so-called “keratinized gingiva”. This is an area of the gums that is fixed to the bone.
When placing the implant it is important that this area is at least 2 mm wide so that the implant can heal. The dentist should therefore make sure that this width is given during planning, otherwise the gum will have to be surgically widened at this point before implantation. In addition, a fixed denture can pose a local risk, as can cement residue.
Cement residues can, for example, come from previously inserted dentures. They remain in the oral cavity and eventually promote inflammation. In addition, fixed dentures can pose a local risk, as can cement residues.
Cement residues can, for example, come from previously inserted dentures. They remain in the oral cavity and eventually promote inflammation. There are several causes of inflammation at the dental implant that can be attributed to the patient.
The most important example is a lack of oral hygiene. The patient should take regular dental care and especially clean the implant with special interdental brushes. On the other hand, smoking must be mentioned here, as tobacco consumption is considered the greatest risk factor. In addition, patients with general diseases such as diabetes mellitus are increasingly diagnosed with periimplantitis, as are patients with pre-existing periodontitis. Further risk factors are:
- Drugs (e.g. immunosuppressive drugs),
- Hormonal changes,
- Irregular dental checks
