Peri-implantitis
Brief description of the condition
Inflammation affecting the soft and hard tissues around implants, leading to loss of bone support.
Key signs and symptoms
- Pain (around the implants)
- Swelling
- Bleeding
- Suppuration on applying pressure
- Radiographic evidence of peri-implant bone loss
Initial management
Recommend optimal analgesia (see Appendix 2).
Do not prescribe antibiotics unless there are signs of spreading infection, systemic infection, or for an immunocompromised patient.
Recommend good oral hygiene.
Advise the patient to seek non-urgent dental care or, if analgesia is ineffective, urgent dental care.
Subsequent care
Assess the patient’s progress including radiographic assessment to evaluate bone loss and monitor the outcome of treatment.
Give appropriate oral hygiene instruction.
Consider non-surgical debridement with carbon fibre or plastic curettes and irrigate the pocket with 0.2% chlorhexidine.
Consider surgical debridement and implant decontamination with saline or 0.2% chlorhexidine.
In severe cases, consider regenerative surgery with barrier membranes with or without autogenous bone grafts or bone substitute or surgical removal of the implant.