Peri-implant Disease: Review of Current Treatment Options and Concepts

In this video, Dr. Ausra Ramanauskaite, reviews cases and research to provide an amazing overview of the current treatments for peri-implantitis.

Main topics include:

• Treatment of peri-implant mucositis, including a review of the current treatments, such as biofilm removal, adjunctive antimicrobial photodynamic therapy, adjunctive local antiseptics/antibiotics, adjunctive systemic antibiotics, adjunctive probiotics
• Nonsurgical treatment of peri-implantitis and its efficacy
• Different surgical treatments, including: reconstructive therapy, combined therapy

Peri-implant diseases are inflammatory conditions caused by bacterial plaque that affect the tissues surrounding dental implants. These diseases are classified into two types: peri-implant mucositis and peri-implantitis. Peri-implant mucositis involves inflammation confined to the soft tissue, while peri-implantitis includes progressive bone loss supporting the implant. The main goals of treating peri-implant diseases are to resolve inflammation and stop disease progression.

The standard treatment for peri-implant mucositis is mechanical biofilm removal combined with improved patient oral hygiene. Treatment outcomes should be evaluated 2 to 3 months post-therapy, with repeated interventions if necessary.

For peri-implantitis, a stepwise approach is recommended, beginning with nonsurgical treatments and progressing to surgical interventions if needed. Surgical treatments include nonreconstructive, reconstructive, and combined methods. Implantoplasty may be used for supracrestal peri-implant defects, while reconstructive therapy is suitable for peri-implantitis with intraosseous defects deeper than 3 mm. Additional reconstructive measures can enhance defect filling and maintain soft tissue levels, which is important in aesthetic cases. The use of systemic antibiotics during surgical therapy does not appear to improve clinical outcomes.

Ongoing supportive peri-implant therapy, including biofilm removal, is essential in the treatment protocol for peri-implant diseases. In cases of significant bone loss around implants that are not crucial for chewing function, immediate implant removal may be considered. 

Source: Ramanauskaite A, Schwarz F. Current Concepts for the Treatment of Peri-implant Disease. Int J Prosthodont. 2024 Apr 22;37(2):124-134. doi: 10.11607/ijp.8750. PMID: 37988432.