Peri-Implant Health

The most common causes of implant failure include poor oral hygiene, a history of periodontitis, and smoking. Inadequate oral hygiene allows bacterial plaque to accumulate on the implant surface, leading to peri-implant mucositis, an inflammatory condition of the mucous membrane surrounding the implant. If peri-implant mucositis is not addressed, it can progress to peri-implantitis, characterised by more severe inflammation and associated bone loss around the implant. As bone loss progresses, the implant may lose its osseointegration, leading to mobility and eventual failure, which could necessitate implant removal and additional surgical procedures to restore the lost bone.

It is important for clinicians to recognise that peri-implant diseases tend to progress more rapidly than periodontitis and are often more challenging to treat. Patients with a history of periodontitis are at a higher risk of developing peri-implant complications, with studies indicating that approximately 22% of implants in these patients may develop peri-implantitis. Therefore, it is critical that patients are free of active periodontitis before implant placement and that they maintain meticulous oral hygiene post-operatively to prevent recurrence of the disease.

Regular monitoring and maintenance are essential for preventing peri-implant disease. Clinicians should educate patients on the importance of thorough home care and the need for regular dental visits to monitor the health of the peri-implant tissues.

Warning signs of peri-implant disease that clinicians should discuss with patients include:

• Increased gum bleeding during brushing or interdental cleaning
• Swelling of the peri-implant tissues
• Halitosis or an unpleasant taste in the mouth
• Mobility of the implant, bridge, or dentures

Early detection and intervention are key to managing peri-implant disease and preserving the longevity of the implant.