Introduction
As the number of dental implants increases globally, the prevalence of peri-implant diseases is also escalating. There are two distinct peri-implant diseases: peri-implant mucositis and peri-implantitis.
Peri-implant mucositis is characterized by inflammation confined to the soft tissues surrounding a dental implant without affecting the supporting bone. Peri-implant mucositis is usually reversible with appropriate treatment. However, if not treated effectively, peri-implant mucositis may progress to peri-implantitis.
Peri-implantitis is a more advanced condition involving both soft tissue inflammation and progressive bone loss, requiring a comprehensive treatment approach to prevent further deterioration and potential dental implant failure.
Focusing on prevention, identifying and decreasing risk factors are important aspects of managing peri-implant diseases. Treatment of peri-implant mucositis involves addressing the etiology of local inflammation, improving oral self-care, and enrolling clients in personalized supportive maintenance programs. Managing peri-implantitis can be challenging. Peri-implantitis therapy may involve nonsurgical, nonreconstructive, reconstructive, and, in some cases, explantation procedures.
Objective
This article provides clinical recommendations and reference flowcharts to manage peri-implant diseases and related complications based on the Academy of Osseointegration (AO) and American Academy of Periodontology (AAP) consensus report on the prevention and management of peri-implant diseases and conditions.
Topics discussed in this article include:
- Risk factors of peri-implant disease, including smoking, plaque biofilm accumulation, inadequate oral self-care, periodontitis, diabetes, obesity, metabolic syndrome, and prosthetic factors.
- Strategies to manage risk factors and peri-implant mucositis.
- Nonsurgical therapy, including mechanical debridement and adjunctive agents, such as chemical irrigation, local and systemic antibiotics, lasers, and probiotics.
- Peri-implantitis management, including nonsurgical, surgical, and explantation procedures.
- Clinical recommendations for supportive peri-implant therapy.
Conclusions
With the exponential increase in dental implant placement, managing peri-implant mucositis and peri-implantitis has become increasingly important. This article presents comprehensive flowcharts to manage these conditions, highlighting the critical role of prevention and early intervention. Appropriate treatment planning, risk analysis, dental implant therapy, and long-term maintenance are vital. Supportive peri-implant therapy and proper oral self-care instruction effectively minimize the risk of peri-implant diseases, underscoring the significance of client education and regular maintenance. Continued research is essential to improve management strategies and enhance the long-term success of dental implants.
