Understanding Peri-Implantitis

Restoration and Implantology
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New review helps clinicians understand dental implant complications

Dental implants are considered a preferable substitute to dentures because they’re more comfortable, stable and functional. Despite these advantages, dental implants can create problems for patients, including a serious inflammatory condition called peri-implantitis which can cause extensive bone loss.

A recent study published in the current issue of the Journal of Oral Implantology examines current scientific literature to gain a better understanding of peri-implantitis and help clinicians more quickly detect and treat the condition.

Researchers from Temple University conducted a systematic search of scientific journal articles regarding peri-implantitis, including 33 articles in their study. The researchers collected data from the papers to answer several questions, including what risk factors and microorganisms are associated with peri-implantitis – and to identify the best diagnostics and treatment options available.

A higher occurrence of peri-implantitis was found among implant patients who were smokers and who had periodontitis, uncontrolled diabetes and cardiovascular disease. The condition was also associated with higher levels of specific cytokines, which are proteins important to the functioning of the body’s immune system.

Additionally, dental implants serve as a surface on which microorganisms can settle and grow. Several bacterial species and viruses such as the Epstein-Barr virus were prevalent in patients with implants who demonstrated with peri-implantitis. These microorganisms can also cause plaque formation and inflammation characteristic of peri-implantitis.

Clinicians now have a concise list of factors that predispose patients with implants to peri-implantitis, and they can closely monitor patients with these risk factors. The authors concluded that after five years post-implant, the risk of peri-implantitis increases, but this issue is alleviated by maintenance programs.

“It is important to realize that dental implants require the same care and maintenance as natural teeth, especially in patients with a high risk for peri-implantitis,” said author Miriam Ting. The authors point out that some surgical and nonsurgical treatments as well as combinations of the two are effective treatments for peri-implantitis.

However, no standard treatment for the condition exists, and the authors were not able to deduce the most effective treatment from the available data. Furthermore, the current literature uses different definitions of peri-implantitis, making it difficult for clinicians to properly diagnose and treat the condition.

It was concluded that future work is needed to standardise the definition of peri-implantitis, and that larger clinical experiments are needed to determine the most effective treatment.

Full text of the article “Peri-implantitis: A Comprehensive Overview of Systematic Reviews,” Journal of Oral Implantology, is available at http://www.joionline.org/doi/abs/10.1563/aaid-joi-D-16-00122.