Peri-Implantitis

Do we really understand the etiology of this disease entity called Peri-Implantitis?? It would seem to form around HA coated implants due to what? Where do the microbes come from? Are they the same ones as in periodontitis?

If so how does this disease spread w/o a pdl. Also I was under the impression that Titanium resisted microbe growth by forming some type of “peroxide gel” due to its “bioactive” surface. The plaque is there but not alot of inflamation. Or when there is inflamation I have not associated it with loss of attachment to bone. Calculous forms on root form implants but with a weak attachment. When removed the underlying tissue does not generally seem raw. And how often do you see sub-gingival calculous around dental implants?? The only times I have seen this is with ging.hyperplasia w/o bone loss. This disease entity has me baffled. I am not so sure that the microbes are the primary causitie agent and are secondary to something else that may have more of a mechanical etiology. The microbes are perhaps just secondary in arriving after the initial insult.. ???

7 thoughts on “Peri-Implantitis

  1. one of the main causes of peri implanitis is actualy iatrogenic because the docror try to do porbing around the implantes opening a way to micr org.
    the other important factor is quantity and quality soft tissue around the implant whish can stand then any mechanical irritation

  2. To DR. Narkede
    I agree. The stress and strain of overload causes fatigue microfractures within the upper body of the implant. These now present metalergy micro cracks set up a nidus or a focal location for the unicellular creatures to have their babies. The rest then becomes clear over time. Exudate, redness, edema, swelling, and bone loss down a couple a threads to about where the abutment screw terminates. Since this is all happening in a saline environment the micro cracks are a set up for a couple and galvanic corrosion.
    As far as treating this condition is where we also have several other issues to address. Once this begins is the moment that implant failure begins. It is like riding on the tire with the nail in the tire. You have a certain amount of time and then it goes down. The failure starts when the nail hit the tire, not when it went flat. Etiology…. OVERLOAD.. Especially when we are talking about late failure vs. early failure. Or even failure at revocery and second stage or at abutment connection. As the great one said remember the lession and loose the failure. Thanks

  3. Dental implants can have infections just as teeth do. Given the dense and diverse population of oral microbes, it should not be surprising that patients are subjected to peri-implantitis and more importantly with periodic episodes of transient bacteremias of oral origins. Even normal, everyday activities such as mastication tooth brushing, and dental flossing have been associated with bacteremias. Sufficient evidence exists to conclude that both periodontitis and peri-implantitis involve the same bacteria, and that the same inflammatory process that damages tissues leads to bone loss and possible implant loss.

  4. A word of caution before choosing to replace teeth with dental implants ( if you have a choice). I understand in Sweden they are seeing a lot of implant failures 15-20 years out for no particular reason, except eventual bacterial infection. Although implants do not decay, they may in time be more prone to breakdown than teeth, and when this occurs around implants it may be more difficult to control.

  5. Can an implant, that failed the first time, be sterilized and replaced or must a new implant be placed?

  6. It can be done. Check the literature, as to how to chemically clean prior to steralization. This was done back in the day just before I got into implants back in the early 90′s. You should also check on the laws of the land where you practice.

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