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An X-ray 2 years after placement, then 7 years later in a heavy smoker. Shows: progression of peri-implantitis

Peri-implantitis is the destructive inflammatory process affecting the soft and hard tissues surrounding dental implants.[1] The array of periodontal pathogens found around failing implants (those affected by peri-implantitis) are very similar to those found in association with various forms of periodontal disease.[2] In compound implants (two stage implants), between the actual implant and the superstructure (abutment) are gaps and cavities into which bacteria can penetrate from the oral cavity. Later these bacteria can return into the adjacent tissue and can cause periimplantitis. As prophylaxis these implant interior spaces should be sealed.[3]


The periimplantitis is caused by a mixed anaerobic microflora, which is at the forefront in the gram-negative bacteria. Staphylococcus aureus can also be involved. However, the events causing the periodontal disease are germs as Aggregatibacter actinomycetemcomitans, Prevotella intermedia, Porphyromonas gingivalis and Treponema denticola are not specific. The germs Tanner forsythia, Campylobacter species and Peptostreptococcus micros are, however, directly linked to the peri. The periimplantitis leads to osteolysis. Comparable to the periodontal disease are primarily plaque deposits responsible for implants for the inflammatory process, suggesting an inadequate oral hygiene. The peri-implant mucosa has less blood flow than the periodontal tissue of the tooth, resulting in a reduced resistance to infection in this area.

Composite implants are between the actual implant and the structure columns and voids into which germs can penetrate from the oral cavity. Later, these germs get back into the adjacent tissue and can cause peri. As prophylaxis this implant interiors should be sealed.


Diabetes, nicotine consumption, bisphosphonate therapy, osteoporosis, immunosuppression, irradiation, bruxism but are also favored by genetic disposition.


Treatment may include removing dead tissue, antibiotics, and improved dental hygiene.[4] This may include the use of mouthwashes[5] and washing with chlorhexidine.[6]


  1. ^ Mombelli, A. "Microbiology and antimicrobial therapy of peri-implantitis," Periodontology 2000 2002;28:177–189.
  2. ^ Listgarten and Lai (2000), AAP In-Service Exam, 2008-B12
  3. ^ Fritzemeier, C. U., W. Schmüdderich: Periimplantitisprophylaxe durch Versiegelung der Implantatinnenräume, Implantologie 2007;15(1):71-80
  4. ^ Hsu, A; Kim, JW (2014). "How to manage a patient with peri-implantitis.". Journal (Canadian Dental Association) 79: e24. PMID 24598326. 
  5. ^ Pedrazzi, V; Escobar, EC; Cortelli, JR; Haas, AN; Andrade, AK; Pannuti, CM; Almeida, ER; Costa, FO; Cortelli, SC; Rode Sde, M (2014). "Antimicrobial mouthrinse use as an adjunct method in peri-implant biofilm control.". Brazilian oral research. 28 Spec. PMID 25003787. 
  6. ^ Renvert, S; Roos-Jansåker, AM; Claffey, N (September 2008). "Non-surgical treatment of peri-implant mucositis and peri-implantitis: a literature review.". Journal of clinical periodontology 35 (8 Suppl): 305–15. PMID 18724858.