What is periimplantitis?
Peri-implantitis is an inflammatory area around the implant, usually with greater bone involvement, as it is rarely discovered in the early stages. The aim after implantation is to allow the implant to heal in the bone. This means that the bone grows directly to the microstructure of the implant surface and adheres to it.
If this healing is disturbed, for example by periimplantitis, there is often only connective tissue healing, if at all, which is less stable. The pathogens are usually anaerobes, i.e. they have a metabolism that does not require oxygen. Also so-called gram-negative bacteria or the well-known skin germ Staphylococcus aureus can be the culprits.
This inflammatory process is negatively intensified by smoking, diabetes, osteoporosis, crunching or genetic predisposition. However, errors in placing the implant due to heat development in the bone and later a mismatch of the associated crowns can also have an unfavorable effect on perimplantitis. It is sufficient, for example, that residual cement with which the crowns were fixed was not completely removed. In order to be able to treat this condition successfully after removal of the remains, a germ test to determine the pathogens, ozone therapy (ozone is trivalent oxygen, a reaction takes place at the implant which kills the pathogens) and an antibiotic adapted to the pathogens found helps. In rare cases, the implant must be removed (replantation) and rebuilt with artificial bone, and after an appropriate waiting period of months, a new implantation must be made.
How does smoking increase the risks?
Every smoker, just like a diabetic, has a greatly increased risk that inserted implants will not heal because the micro blood circulation is disturbed. This means that the number and quality of the smallest blood vessels, the capillaries, is reduced: the superficial tissues are not sufficiently supplied. However, this is absolutely necessary, among other things so that, in the event of invading germs, the cells of the immune system are able to migrate to the site of inflammation and fulfill their task.
In addition, the contents of the smoke endanger the entire oral mucosa. Smokers therefore have a greater risk with regard to wound healing. This applies to the mucous membrane as well as to the bone. Peri-implantitis (inflammation around the implant) is also much more common in smokers and the rate of implant loss is also significantly higher in smokers than in non-smokers.
