Bone inflammation of dental implants (peri-implantitis)

Robert Novoski

In the end, cost is the only factor that in most cases is the reason for the integration of a bridge or prosthesis rather than the use of one or more implants.

Although the need for preoperative preparation is usually well understood by patients, it is not always possible to achieve sufficient motivation to carry out regular check-ups after the procedure and denture fitting. But aftercare is very important. Regular appointments for professional teeth cleaning at intervals of approximately 3 months are important, for example: B. to avoid the development of peri-implantitis. Peri-implantitis is bone inflammation that can form around an implant. This is accompanied by bone loss, pocket formation and, following extensive bone loss, can ultimately lead to loosening of the implant resulting in implant loss. In addition to planning problems (e.g. incorrect crown-root ratio), inadequate hygiene after prosthetic treatment of implants is the most common cause of peri-implantitis.

If a diagnosis of peri-implantitis is established, a specialist implantologist (specialist in oral and maxillofacial surgery) should be consulted to initiate prompt treatment of these inflammatory changes. In addition to proper definition of the spectrum of germs present and antibiotic coverage, the most important thing is to remove the inflammatory tissue around the implant. Ideally this can be done with a laser. Bone defects that arise around the implant must then be repaired with appropriate reconstructive procedures.

Different materials are available for this. A rough distinction can be made between synthetic materials or bone materials. The use of animal bones – even in processed form – is increasingly discouraged because, despite the very high level of viral safety, there is always the fear that viruses can be transmitted through animal bones. So it is better to use your own body bones, for example. B. can be obtained from the iliac crest, kneecap, lower leg bones or even in the oral cavity. This bone is then processed and inserted into the deformed bone. It is important that this bone is stabilized in the defect and that mobility does not occur in the transplant, as moving bone is absorbed relatively quickly, leading back to the original problem. At least when using synthetic bone, covering it with an absorbable membrane is essential. In this way, in the majority of cases, inflammation around the implant can be controlled and the implant can be maintained. If it is not possible to increase bone damage due to, for example, B. Bone being repeatedly lost due to various reasons, it is very important to at least maintain its cleansing ability.

In short, it can be said that the care after implantation and integration of implant-supported dentures is at least as important as the pre-implantation and implantation measures themselves.

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