Periimplant tissue breakdown

Abstract

Osseointegrated implants in the oral cavity can be regarded as analogous to natural teeth and both are colonized by similar groups of oral bacteria. Hence, the principles and mechanisms of both periodontal disease and peri-implantitis are similar. Implants suffering traumatic failure have subgingival microflora resembling that of periodontal health, with cocci and non-motile rods as the predominant morphotypes and Streptococcus and Actinomyces species as the predominant cultivable microflora. In contrast, spirochetes, motile rods, non-motile rods and cocci are seen in the infected implants. Peri-implantitis surrounding oral implants is an inflammatory process affecting the soft- and hard tissues resulting in rapid loss of the supporting bone. Various therapies have been advocated for the resolution of peri-implant infection and restoration of peri-implant tissues. These include access flap surgery, debridement of implant surfaces, chemical conditioning, bone regenerative procedures and topical and systemic antibiotic therapy. Regardless of the prevalence of peri-implantitis, which is about 5-8%, every affected implant represents a threat to the longevity of the associated prosthetic replacement. Therefore, detection and treatment of early pathogenic changes during regular recall maintenance visits prevent peri-implant soft-tissue inflammation and progressive bone loss.