Peri Implantitis
Ninian Peckitt
FRCS FFD RCS FDS RCS FA
Oral and Maxillofacial Surgeon / Facial Plastic Surgeon
Peri Implantitis
Around 500,000 Dental Implants are placed in the U.S. per annum. Complications are not uncommon and at British Dental Place we have a strategy to address this problem.
Peri–implantitis is the destructive inflammatory process affecting the soft and hard tissues surrounding dental implants. It may range from mild inflammation of the gum to severe bone loss – with the loss of the implant.
It is thought that one third of those patients have a milder untreated gum disease can develop into peri-implantitis.
Long term dental care is essential, for all patients.
Our patients are supervised in telemedicine clinics and subject to clinical audit.
So why does peri-implantitis happen?
The key issue is related to the implant itself, its design and the mechanics of how it is loaded.
Most dental implant systems come as a two-part device. The implant which is placed into the bone and the abutment which fits into the implant and receives a dental crown.The join appears to be critical.
Bicon developed a locking abutment system which is tapped into the implant to produce a “cold weld”. This significantly reduces micromovements leakage of bacteria into the mouth. If an implant system has abutments that loosen or fracture, this is indicative of micro movements and system instability.
Placement Deep to Bone Surface
If a shouldered implant is placed deep to the bone surface, bone grows over the implant burying it. If bone grows up the implant it is not being lost, and this is a key issue in the prevention of peri implantitis and implant loss.
Implant Diameter and Emergence Profile
The diameter of the implant should mirror the diameter of the tooth it replaces. This is important in dental aesthetics.
The Three Principles for Long term stability:
- Macrodesign should include a shoulder for bone envelopment
- Tapered Mortise Abutment System to prevent bacterial leakage
- Subcrestal Bone Placement to promote vertical bone growth
The Three Principles for Long Term Stability
The Stability Cycle
All our implants are placed in accordance with these principles to address the pandemic of peri implantitis currently estimated >40% – 80% of Global Implants placed.
We have yet to observe a case of peri implantitis with this protocol and shall be auditing our cases carefully.
