Periimplantitis is a harmful inflammatory process.

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Management of Peri-implantitis

It was once believed that dental implants were impervious to dental infections.

However, increasing evidence suggests that dental implants can be affected by gum disease similar to teeth.

There is a varying spectrum, like Periodontal Disease of natural teeth, as to how the infection affects and damages the interface between implant and bone.

Thus, proper post-treatment care of any implant is critical to the longevity of the treatment. Read more.

The Peri-implantitis Process

It can start with a type of allergic reaction to the bacteria that is left sitting around an implant and not cleaned away. This plaque becomes hardened over time only to attract more plaque.

This causes the soft tissues and gums to react by swelling and easily bleeding on brush or with simple agitation.

This is followed by an invasive process starting with a loss of detachment of the gum and soft tissues surrounding the dental implant. It is seen as pocketing around the implant.

The inflammation is as a result of the toxins in bacteria. This causes further bleeding and swelling.

If left to persist, then the infection spreads to the bone. The bacteria invade the bone, breaking it down and causing further tissue damage.

The process of osseointegration (where the bone connected with the threading in the dental implant during the healing phase) is unravelled. The bone supporting the implant then begins to deteriorate away, loosening the implant.

Since the dental implant is often covered with a crown, bridge or prosthetic (denture), any biting pressure will simply make the infection around the implant worse.

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Causes of Peri-implantitis

  • Poor Oral Hygiene. If regular hygiene appointments are not maintained, and there is a lapse of good home teeth cleaning, then infection can build up.
  • An ill-fitting crown or prosthesis prevents optimal cleaning.
  • Over bulbous prosthesis or crown again preventing easy cleaning ability.
  • A loose screw in a screw-retained crown on the implant. This can act as a plaque trap.
  • Excess cement was not removed during the fitting of a crown. This can act as a plaque trap.
  • Incorrect Implant position. If a 3-4 mm biological barrier is invaded during the positioning of the implant, then any subsequent infection will easily invade the osteointegration zone of the implant.
  • Incorrect loading placed from the prosthesis, bridge or crown surface. This means the bite is unbalanced and unstable causing at first mechanical loading on the implant and subsequent biological degradation.
  • Incorrect Implant design used which is incompatible with the patient’s mouth.

Correct Diagnosis

This requires a clinical examination of the tissues around the implant and a radiographic evaluation. Read more.

The dentist will look at all the following aspects of the dental implant:

  • Occlusal Loading
  • Gingival evaluation
  • Both vertical and horizontal bone loss around the implant
  • Any detachment of the gum
  • Signs and symptoms indicating infection
  • The extent of mobility of the implant

Types of Peri-implantitis

  • Peri-Implant Mucositis is when there is an infection around the soft tissues and gums surrounding the gum. This starts off an inflammatory process. Statistics show that 30% of dental implant failures are because of gum disease around the implant.
  • Peri-Implantitis is when there is both soft and hard tissue deterioration. It starts as an infection in the gums but then becomes aggressive to infect the bone. When this happens, the bone begins to detach and disintegrate.

Symptoms of Peri-implantitis

The symptoms will vary according to the severity of the condition and type of peri-implantitis:

  • Bleeding and changes in the colour of the gums 
  • Swelling and oedema 
  • Pus, pocketing and pain
  • Prosthesis instability
  • Gum detachment
  • Bone loss & disintegration
  • Loose implants

Treatment of Peri-implantitis

Our treatment will differ depending on whether the diagnosis is Peri-Implant Mucositis or Peri-Implantitis. The first protocol, regardless of diagnosis, involves management and control of the infection.

The treatment involves the removal and debridement of the infected tissue. This can be carried out under local anaesthesia.

It may or may not involve surgery of the gums. It can also include regenerative and respective surgical techniques. We care for nervous patients.

It is important to use instruments that are softer than titanium to clean the implant site. These can be a non-metallic tip, resin/carbon fibre curettes, or an ultrasonic cleaner.

Prevention of Peri-implantitis

Prevention is better than any treatment protocol subsequently. Early detection is key to a successful outcome.

It is essential to minimise any risk factors that can worsen the problem, such as smoking.

Mechanical Debridement is Usually Necessary

There is now also laser therapy that can be done to facilitate better healing and bio-stimulation of the bone.

Antibiotics often support the treatment. This is then followed by a healing phase and subsequently a re-assessment phase.

You should follow a strict home tooth cleaning program as soon as you decide to have implants placed.

It will become very important that you are regularly seen by our hygiene therapist so that she can keep an eye on you before, during and after your dental implant treatment.

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What our Patients Need to Know

Learn more about what we offer here at the Perfect Smile Studios.

Many reasons patients in London and beyond choose us is because of our attention to detail, the care we provide, how we prepare and the results we achieve.

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At The Perfect Smile, we understand that patients may be naturally nervous when thinking of undergoing dental implant surgery.

We want to reassure you that the dental implant treatment is not painful due to the proper use of local anaesthetics to numb the bone and gum deeply.

We can also use sedation techniques that also contribute to no pain or discomfort. More.

Treatment Plan
  • Step 1: We will start the process with a highly detailed and thorough comprehensive examination and assessment. We will then construct a customised treatment plan and design your implant treatment.
  • Step 2: An implantologist surgically places your new implant(s) in your mouth.
  • Step 3: We will assess your healing on this review appointment and make sure everything is going as planned.
  • Step 4: The dentist records and impressions to construct the implant’s top part (post and crown).
  • Step 5: The dentist will fit the final part of the implant (post and crown).
  • Step 6: Your final appointment allows you to have any further refining cosmetic enhancements or minor adjustments.


Fast Process

  • Minimal appointments: Unlike traditional dental implant surgery, you will need fewer appointments
  • No lengthy treatment time: The healing time is fast and effective, though individual to each person.
Bone Quality
  • When you lose a tooth, the surrounding bone that holds the tooth in place will diminish in height, width, and volume. This may affect the immediate and final appearance of the gum tissue in this area and possibly the surrounding teeth.
  • The larger the width of bone or the height of the bone, the wider and longer implant can be. A wider and longer implant increases implant stability and thus success. We assess the bone height and width by taking digital radiographs or by taking a CT Scan. More.

Implant Costs

The price of a dental implant can depend on whether any further treatments are needed to make sure your implant is a success.

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Implant FAQs

  • Will Dental Implants Last a Lifetime? Once the implant has fused with your jawbone and tissues, the artificial titanium implant acts as an ordinary root. The longevity of your implant depends on how you improve and maintain your oral health. Read more.
  • Does a Dental Implant Hurt? When we place the implant, we make sure the procedure is pain-free. We offer a range of sedation and techniques suitable for nervous patients. You can find out more here.
  • How Old Do I Have to Be for a Dental Implant? There isn’t an age limit for dental implants. However, our dentists recommend that you have to be over 18 for the dental implant procedure. Read on.
  • Is a Dental Implant Treatment Safe? We also use extensive planning systems to ensure the implant treatment is successful. Find out more.
  • Are Dental Implants Worth It? A dental implant offers a wealth of oral health benefits. An implant can improve your smile, realign neighbouring teeth, protect your mouth from gum disease, etc. Read the benefits.
  • Is the Process Painful? You can expect to feel pain with a new implant; however, the discomfort is kept to a minimum with modern anaesthetics. Nevertheless, post-process, there can be some swelling and aching for 5 -10 days. Many patients have multiple implants in a single day without undue pain or distress. More.

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Contact us for any questions, requests and further information; or to arrange a FREE Initial Consultation.
Our free no obligation Initial Consultation will be with our dentist and/or our Treatment Coordinators. The suitability of options discussed will ultimately be dependent upon your clinical assessment with a dentist at the practice.
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    Highly Experienced Implant Team

    An unparalleled level of patient trust: Dr Rahul Doshi is the founder of the Perfect Smile and is the current President of the BACD.

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    Successful Dental Implants Can Last a Lifetime

    Once the implant has fused with your jawbone and tissues, the artificial titanium implant acts as an ordinary root.

    When we implant a titanium implant into the jawbone, it becomes part of your oral foundation.

    This offers several health benefits that include preventing any bone loss whilst supporting the jawbone structure and reducing the risk of gum disease. More.

    “If treated correctly, dental implants can last from ten to twenty-five years or more.”

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    The longevity of your implant depends on how you improve and maintain your oral health. Read more.