Protection against peri-implantitis
Although implants can not get sick, they can be lost if there is a lack of oral hygiene. An implant needs a clean and bacteria-free environment. Bacterial inflammations on the oral mucosa adjacent to the implant endanger the long-term success of an implant treatment.
Like natural teeth, which are endangered by a lack of care by a periodontitis, so-called peri-implantitis can occur after successful healing or osseointegration with insufficient oral hygiene on the implants. These peri-implant inflammations around the implant are the most common cause of late complications, which in the worst case can lead to the loss of an implant.
After implant placement and osseointegration, regular follow-up and professional teeth cleaning provide protection against peri-implantitis and mucositis.
Prevention protects against these inflammations
At the time of implantation, patients are often unaware that the peri-implant tissue can also become inflamed. These peri-implant inflammations around the implant are the most common cause of late complications, which in the worst case can lead to the loss of an implant. Only prevention protects against these inflammations. When the peri-implant tissue around an implant becomes inflamed, there is a risk of mucositis and, as a result, the risk of peri-implantitis.
This prevention protects against these inflammations and begins even before implantation. Good oral hygiene and a healthy condition of the gums and teeth are prerequisites for planning a successful implant treatment. After the healing of the implants, this treatment success can only be ensured with appropriate oral hygiene. The care at home must be supplemented by a regular check and professional prophylaxis in the dental office. In the case of implant prophylaxis in practice, deposits, bacterial colonization (plaque) and the pathogenic biofilm are removed at locations of the implant that are difficult to access for the patient.
Signs of peri-implantitis
Mucositis is similar to gingivitis. Mucositis causes bleeding, but the bone is not yet attacked and there is no sign of bone loss.
The sooner a peri-implantitis is diagnosed, the higher the chances of successful therapy. With timely diagnosis, the dreaded bone loss around the implants can be prevented. The enlightenment of the patient plays a special role.
The first signs of peri-implantitis are redness, bleeding and swelling of the gum surrounding the implant. The symptoms of peri-implantitis are difficult to detect by patients, as they are usually painless. At the beginning, the infection is still limited to the soft tissue. It comes to a peri-implant pocket formation of about 4mm pocket depth and damage to the connective tissue. The inflammation causes bone adjacent to the implant to creep, retard, and eventually loosen for several millimeters of bone.
Therapy of peri-implantitis
In the initial phase, the bacteria and the inflammatory germs on the implant surface are removed, and then the contaminated surface of the implant is disinfected. It will remove roughness and deposits on the implant and any dirt niches removed to prevent re-plaque accumulation. A smoothed implant surface promotes improved hygiene and is said to reduce peri-implant inflammation.
For further cleaning, ultrasound systems with modified ultrasound can be optimized for peri-implantitis treatment. The biofilm removal can be supplemented with air powder water jet devices with low-abrasive powder jet technology. With the use of additional laser therapy, bacteria can be safely eliminated. This mechanical cleaning of the implant surface may be assisted with antibiotics to reduce the bacterial load on titanium surfaces and to treat the acute inflammation. However, the cause of peri-implantitis has no influence on the antibiotics.
A patient must be prepared to optimize implant care, as lack of care is the greatest risk to peri-implantitis. Problems can only be avoided with a structured aftercare concept and a systematic, close-knit recall.
Open surgical procedure
After these antiseptic measures, further minimally invasive steps can be taken. After bone loss additional surgical intervention is required. In this open surgical procedure, the surface treatment of the implant can be combined with regenerative techniques to compensate for bone loss. These regenerative measures work with bone substitute materials which, protected by membranes, are supposed to promote the new attachment of bone. The therapeutic goal is a situation without clinical signs of inflammation and the maintenance of implant function as well as a band of attached mucosa around the implant.
Implants – an investment in quality of life
The goal of any implant treatment is to obtain a natural, tight-fitting denture that is safely healed and no difference to natural teeth is felt.
Conscientious oral hygiene is a prerequisite for enjoying implants for a long time. Natural teeth, as well as the new implant-supported teeth, should be cleaned after every big meal. The goal of thorough dental care is the gentle removal of soft plaque and incipient calculus deposits.
After the healing of the implants, the success of the treatment can only be ensured with appropriate oral hygiene. The care at home must be supplemented by a regular check and professional prophylaxis in the dental office. In the case of implant prophylaxis in the dental office, deposits, bacterial colonization (plaque) and the pathogenic biofilm are removed at locations of the implant that are difficult to access for the patient.
Especially elderly or dependent people with limited motor skills and diminishing eyesight need the support of their caregivers and their social environment when cleaning and maintaining their implant-supported dentures.
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