What is it?
Peri-implantitis is bacterial inflammation in the gum and bone surrounding an implant. It first involves only the soft tissue (peri-implant mucositis), and that stage is reversible. Once bone loss begins, the loss is permanent.
Its most deceptive feature is how quiet it is. Because there is no nerve in an implant, pain usually appears late; the first thing the patient notices is often bleeding, a bad taste, or slight movement in the implant.
Signs
You will not necessarily have all of these at once.
Why does it happen?
- 01
Inadequate interdental cleaning
Plaque around an implant converts into bone loss faster than around a natural tooth; cleaning matters more here.
- 02
A history of gum disease
In patients who lost teeth to periodontitis, the risk of peri-implantitis is clearly higher.
- 03
Smoking
By reducing blood supply it raises both the risk of onset and the speed of progression.
- 04
An ill-fitting superstructure
A crown margin that cannot be cleaned, or residual cement, creates a permanent shelter for bacteria.
How does it progress?
- Stage 1
Mucositis
Inflammation in soft tissue only; bleeding is present, bone loss is not. This stage is reversible.
- Stage 2
Early bone loss
The pocket deepens and bone loss becomes visible on the radiograph. The aim is to halt progression.
- Stage 3
Advanced loss
Movement in the implant and marked bone loss; removing the implant may come into play.
How is it treated?
At the mucositis stage a professional cleaning plus corrected home care is enough in most cases. Because the implant surface must not be scratched, special instruments are used instead of standard ultrasonic tips.
Once bone loss has begun, surgical cleaning, surface decontamination and, in suitable cases, grafting are used. The aim is to stop the loss rather than reverse it, which is why catching it early is decisive.
- A sense of movement in the implant
- Discharge from around the implant
- Gum recession exposing the implant surface
- Swelling or pain
How is it prevented?
- Clean around the implant daily with an interdental brush or a water flosser
- Have check-ups every six months at a practice experienced with implants
- Stopping smoking lowers the risk directly
- Do not wait when you see bleeding; mucositis is the only reversible stage
Frequently asked questions
- Can an implant decay?
- No, titanium does not decay. The risk lies not in the implant itself but in the gum and bone holding it.
- Does lost bone come back?
- Not on its own. In suitable cases it can be partly regained with a graft; the main goal is to stop the loss.
This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.