BASAL DENTAL IMPLANTS AS A MODERN SOLUTION TO ADVANCED PERIODONTITIS

Last updated on: 16 Jun, 2026

Leading surgeon and implantologist Dr Radoslav Simeonov discusses the challenges of one of the most common dental conditions – advanced periodontitis – as well as modern treatment alternatives using basal implants.

Periodontitis (also known as periodontal disease) is a serious gum disease that affects millions of people worldwide. This inflammatory condition destroys the tissues around the teeth and can lead to tooth loss. Understanding the symptoms, causes and treatment methods is important for maintaining good gum health and overall health.

What is periodontitis?

Periodontitis is a chronic inflammatory disease that affects the periodontium – the structures supporting the teeth. This includes the gums, the periodontal ligament, the cementum and the alveolar bone. The condition begins as gingivitis, but if left untreated, it progresses to a more serious form.

The inflammation causes gradual destruction of the supporting tissues. This leads to the formation of gum ‘pockets’ – spaces between the tooth and the gum where bacteria accumulate. Over time, the bone is resorbed and the teeth begin to wobble.

What are the most common symptoms?

The usual symptoms of periodontitis develop gradually and often go unnoticed in the early stages. Early recognition of the signs is essential for successful treatment.

Bleeding and pain in the gums

Bleeding gums are one of the first signs of periodontitis. This occurs when brushing teeth or using dental floss. The gums become red, swollen and painful to the touch. The resulting gum sensitivity is particularly pronounced when consuming cold or hot foods.

Unpleasant smell and taste

The inflammation of the gums itself often causes a persistent, unpleasant odour in the mouth. Patients experience a metallic or bitter taste that does not disappear after brushing their teeth. This is due to the toxins released by bacteria in the periodontal pockets.

Changes in the appearance of the teeth

The gums begin to recede, making the teeth appear longer. Gaps appear between the teeth that did not exist before, and the teeth may shift position or become loose.

Discomfort when eating

Patients experience pain or discomfort when chewing. This makes it difficult to eat solid food and has a negative impact on digestion. In advanced cases, the pain may be constant.

What are the causes of periodontitis?

The various causes of periodontitis often act in combination. Understanding them helps with more effective prevention of periodontitis.

Poor oral hygiene

Inadequate oral hygiene is the main cause of the disease. Plaque that builds up on the teeth turns into tartar, which cannot be removed by ordinary brushing. The bacteria in the plaque release toxins that irritate the gums and cause inflammation.

Smoking and alcohol

Smoking reduces blood flow to the gums and suppresses the immune system. This makes the tissues more vulnerable to infection. Alcohol consumption also has a negative impact on gum health.

Genetic predisposition

Hereditary factors play an important role in the development of periodontitis. Some people have a genetic predisposition to more aggressive forms of the disease. This explains why, with the same oral hygiene, different people may have different outcomes.

Systemic diseases

Diabetes, cardiovascular disease and autoimmune conditions increase the risk of periodontitis. Hormonal changes during pregnancy and the menopause can also cause gum problems.

Stress and lifestyle

Chronic stress weakens the immune system and makes the body more susceptible to infections. Poor diet, particularly the consumption of sugar and processed foods, also contributes to the development of the condition.ducing the inflammatory symptoms – pain, bleeding, teeth stability.

Risks and complications

Untreated periodontitis leads to serious health problems that extend beyond the oral cavity. Early recognition of the risks is important for motivating patients to seek treatment.

Cardiovascular diseases

Studies show a link between periodontitis and an increased risk of heart attack and stroke. Bacteria from the mouth can enter the bloodstream and cause inflammation in the blood vessels.

Diabetic complications

In patients with diabetes, periodontitis can make it harder to control blood sugar levels. Inflammation negatively affects insulin resistance and can lead to a higher incidence of diabetic complications.

Respiratory infections

Aspiration of bacteria from periodontal pockets can lead to lung infections, particularly in older people or patients with weakened immune systems.

Problems during pregnancy

Pregnant women with periodontitis are at higher risk of premature birth and having babies with low birth weight.

How is periodontitis diagnosed?

An accurate diagnosis of periodontitis requires a professional dental examination and specialist tests. Early detection allows for more effective treatment.

Clinical examination

A periodontist carries out a detailed examination of the oral cavity. They measure the depth of the periodontal pockets using a special probe and assess the degree of gum inflammation, tooth mobility and loss of stable attachment.

X-ray examinations

X-rays show the extent of bone loss around the teeth. Panoramic X-rays provide an overview of the condition, whilst targeted images provide detailed information on specific areas.

How is periodontitis treated?

The specific treatment for periodontitis depends on the severity of the condition and involves various approaches – ranging from conservative methods to surgical interventions.

Non-surgical treatment

Professional teeth cleaning is the first step in treatment. This involves removing plaque and tartar both above and below the gum line. Ultrasonic instruments and hand scalers are used.

Surgical treatment

Surgical treatment of periodontitis is used in advanced cases where conservative methods are insufficient.

Surgical procedures allow direct access to the roots of the teeth for more effective cleaning. The surgeon cuts and lifts the gum tissue, cleans the infected areas and sutures the tissue back into place.

Implant treatment

In severe cases involving tooth loss, dental implants are used. Basal implants are particularly suitable for patients with periodontitis, as they are placed in healthy bone and have a smooth surface that prevents the build-up of bacteria. Dental implants allow for the restoration of both function and the aesthetics of the smile. 

Additional therapies

Standard physiotherapy for periodontitis includes laser therapy, ozone therapy and plasma therapy. These methods aid healing and reduce inflammation. 

PRF (platelet-rich fibrin) therapy uses the patient’s own blood to stimulate tissue regeneration. The method is safe and effective when applied correctly.

Prevention of periodontitis

Preventing periodontitis is the most effective way to avoid the condition. Regular care and healthy habits play a key role.

Daily oral hygiene

Teeth should be brushed properly at least twice a day using fluoride toothpaste. An electric toothbrush may be more effective than a manual one at removing plaque. 

Flossing is essential for cleaning the spaces between the teeth, and antibacterial mouthwashes complement daily hygiene.

Regular dental check-ups

Regular dental check-ups should be carried out every 6 months, or more frequently for high-risk patients. Professional teeth cleaning removes build-up that cannot be removed at home.

Healthy lifestyle

A healthy diet rich in vitamins and minerals supports gum health. Limiting sugar and processed foods reduces the risk of disease, and giving up smoking significantly improves gum health. Stress management and regular physical activity also contribute to good oral health.

Timely treatment of gingivitis

Gingivitis is a reversible form of gum inflammation, and its timely treatment prevents progression to periodontitis. At the first signs of gingivitis, professional help should be sought immediately.

Final thoughts

Periodontitis is a serious condition that requires professional attention and long-term care. Modern methods of treating periodontitis offer excellent opportunities for managing the condition and restoring oral health.

Remember that prevention comes before treatment. Invest in good oral hygiene and regular dental check-ups, as this is the best insurance for your health.