Dental Implants and Peri-Implantitis

Peri-implantits is a new type of inflammatory disease related to the rise of conventional dental implants’ application. There are different problems and aspects affecting patients who have been treated with classic (two-stage) dental implants for missing teeth, that set new challenges for the modern implantological practice.

According to latest studies in the field of dental implantology, there is an increase in peri-implantitis cases ranging from 10% to 35% for the last 5 to 10 years. This makes the preliminary, detailed consultation with an experienced implantologist absolutely important, given the mere fact that conventional implants are a specific treatment that is not suitable for all types of patients!

What Is Peri-Implantits and Why Does it Occur?

Peri-implantitis represents a progressive and irreversible disease of the hard and soft tissues surrounding the classic, two-piece dental implant. It generally affects patients that are not eligible for conventional implants, due to lack of proper conditions for integration between the jawbone and the implant.

Other factors such as poor mouth hygiene following the implant insertion can also be considered for resulting in complications and inflammation in the implant area.

Peri-Implantitis Stages

There are 4 main stages that characterize the peri-implant inflammation. They are highly dependent however, on the extent of bone resorption surrounding the implant, the level of decreased osseointegration, presence of increased pocket formation and purulence.

The initial peri-implantitis stage is known as peri-mucositis, characterised by gum inflammation, that can be expressed in reddening, swelling and purulence.

The most severe conditions of peri-implantitis can even lead to the complete implant loss.

Peri-Implantitis Risk Factors

The most common risk factors that may lead to a peri-implant inflammation are:

• Rough implant surface that accommodates bacteria and plaque.
• Poor oral hygiene following the implant surgery.
• Smoking after implant surgery and smokers in general.
• Previous periodontal inflammations or disease.
• Bruxism (teeth grinding).
• Poor fitting between the crown and remaining teeth.
• Cement particles surrounding the implant.

Peri-Implantitis Therapy

Peri-implantitis therapy is a very complex process and takes place in several phases. The overall treatment system represents a combination of surgical and non-surgical methods, together with antibiotic medication. The most common procedures applied involve chemical anti-microbe (medication treatment) and mechanical (manual) therapy using special curettes, ultrasonic and air polishing systems.

It is extremely important to achieve a significant improvement of the patient’s overall hygiene habits and correction of the occlusion.

The existent risk and overall rise in peri-implant inflammation cases over the years does not mean in any possible way that conventional implants should not be applied for treatment. On the contrary, there are certain clinical cases that are eligible only for classic implants and it is of high significance that patients work with an experienced implantologist for determining, assessing and elaborating the correct selection of implants for their individual treatment.

Dental Implants at Dentatime

At Dentatime, we provide implant treatment both with conventional (classic) implants and Swiss immediate load basal implants, which are characterised by a number of advantages when considering peri-implantitis prevention for patients at risk. We spend time with our patients for consultation to discuss in detail their individual cases and type of implant treatment to be applied.

The most important part prior to planning a basal implant treatment is the X-ray (OPG) or 3D digital scan examination (CBCT). This is what you need to have before you schedule a detailed consultation with Dr. Radoslav Simeonov at the Dentatime Clinic for treatment options. After the check-up, our patients are offered individual treatment plans and are followed on in detail throughout the treatment and post-treatment phases.


Please, check out all the type of implant treatments offered at our Dentatime Clinic at the Dental Implants section on our website.

Dr. Radoslav Simeonov