33
Volume1 Issue6
|
S
upporting
Y
our
P
ractice
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How toManage a
PATIENTWITH
PERI-IMPLANTITIS
Point ofCare
Peri-implantitis
Infectious disease that causes an inflammatory process
in the soft andhard tissues surrounding an osseointe-
grated implant, leading to the loss of supporting bone.
Presentation
Population
Patientswith implants
RiskFactors
•
Tobaccouse
•
Poorlycontrolled systemicconditions (e.g., diabetesmellitus, osteopo-
rosis, post-irradiated jaws)
•
Historyof periodontitis andnoncompliance to treatment
•
Poor oral hygiene
•
Parafunctional habits (e.g., bruxism)
•
Iatrogenic factors (e.g., lackof primary stabilityandpremature loading
during thehealingperiod)
Signs
•
Progressive increase inprobingdepth
•
Suppurations andexudation fromperi-implant space
•
Bleedingonprobing
•
Clinical appearanceof inflamed tissue (bleeding, swelling, colour
change, suppuration, andplaque/calculus accumulation)
•
Progressive lossof supportingboneon follow-up radiographs
(see
Figs. 1
and
2
): lossof supportingbonebeyond0.2mmannually,
after theexpectedphysiologic remodelling.
Symptoms
•
Not always symptomatic
•
Pain severity: typicallynone
•
Mayhavedull aches, tendernessonbrushingor palpation
•
Bad taste: potentiallynoticeable if therearepurulent exudates
•
Increasingmobility (incasesof a failed implant)
•
Lymphadenopathy
AndreaHsu
DMD,MSc,FRCD(C)
Dr.Hsumaintains
a private practice in
Montreal,Quebec.
Jung-WanMartin
Kim
DMD,FRCD(C)
Dr.Kimmaintains
a private practice in
Vancouver, British
Columbia.
The authors have no
declared financial
interests.
This article has been peer
reviewed.
DentalEmergency
Scenario
