Despite the very high success and survival rates of dental implants, complications do arise. While most of these are technical in nature, biological complications can have serious consequences and compromise the integrity of the restoration.
Bone loss around an implant can lead to soft tissue recession which can have a disastrous aesthetic outcome. While not all bone loss is due to peri-implantitis, this is one of the complications we are seeing with an increasing frequency. It has been difficult to determine the exact prevalence of peri-implantitis, due to the multitude of different implant systems available and the difficulty in determining a diagnostic threshold for the disease. Mombelli et al 2012 published a review on the epidemiology of peri-implantitis – reporting a prevalence of peri-implantitis in the order of 10% around implants and occurring in 20% of patients.
While the exact prevalence has been difficult to determine, we are starting to establish a risk profile to identify individuals who are more prone to this disease. The major risk factors include poor oral hygiene, smoking and a history of periodontal disease. This last risk factor is particularly interesting – is this due to the similar microbial biofilm seen in periodontal disease and peri-implantitis or is this due to the underlying host response? To minimise this risk patients need to be periodontally stable prior to embarking on implant therapy and they should be committed to regular maintenance.
** Clinical radiographs supplied below reflect cases treated by Periocare.