Peri-Implantitis: A Review of the Disease and Report of a Case Treated with Allograft to Achieve Bone Regeneration

Abstract

Dental implants offer excellent tooth replacement options however; peri-implantitis can limit their clinical success by causing failure. Peri-implantitis is an inflammatory process around dental implants resulting in bone loss in association with bleeding and suppuration. Dental plaque is at the center of its etiology, and in addition, systemic diseases, smoking, and parafunctional habits are also implicated. The pathogenic species associated with peri-implantitis include, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythia. The goal in the management of peri-implantitis is the complete resolution of peri-implant infection with function. Therapies using various biomaterials to deliver antibiotics have been used in the treatment of peri-implantitis e.g. fibers, gels, and beads. The use of guided tissue regeneration barrier membranes loaded with antimicrobials has shown success in re-osseointegrating the infected implants in animal models. Several uncertainties still remain regarding the management of peri-implantitis. The purpose of this article is to present a background of peri-implantitis along with a case of peri-implantitis successfully treated for bone regeneration.

Complications in implant dentistry

“…[73,74,81] The incidence of peri-implantitis and implant loss could be greater if the studies with longer follow-up periods are evaluated. [82] In a healthy environment around the implant, the tissues play a pivotal role in preventing the spread of agents that can be pathognomonic, and if the biological barrier is breached, it could lead to bacterial contamination around the bone resulting in hasty destruction of the tissues surrounding the implant. [83] The peri-implant disease is also related to unequal occlusal load distribution, which may lead to loosening of the superstructure, infection of the surrounding area, eventually culminating into the inflammatory process.…”

“…The peri-implant disease treatment strategies have been explored and employed to prevent failure of the implant treatment. [82] They include nonsurgical mechanical debridement, local antimicrobial delivery in periodontitis and peri-implantitis, and surgical debridement with bone grafting. Implant removal is warranted if there is more than 60% of bone loss following peri-implantitis, and there is an evidence of mobility.…”

Mechanical, technical, and biological complications of dental implants

“…Therefore, further studies with more extended follow-up periods are encouraged to estimate the true incidence of this complication. 33 Intervening against the development of periimplantitis and spread to causative organisms is usually achieved by the sound dental and oral environment surrounding the implant. Breaching this biological barrier by any etiology can significantly lead to bacterial contamination around the area of implantation.…”

“…The presence of periimplantitis can progressively lead to implant failure. 33 Therefore, different prevention strategies were reported in the literature to prevent the development of the condition and adequately deal with it. Some of these strategies include surgical debridement of the affected tissues with bone grafting and the administration of antimicrobial modalities to eliminate periimplantitis and periodontitis.…”

DNA-aptamer-nanographene oxide as a targeted bio-theragnostic system in antimicrobial photodynamic therapy against Porphyromonas gingivalis

“…Today, surgical and non-surgical treatments are performed for periodontitis. Pharmacological intervention and surgery are considered the gold standard therapeutic protocol for advanced periodontitis, which may be associated with a high level of displeasure in the patient 3 . Although non-surgical treatment can improve important clinical parameters, microbial pathogens are not significantly reduced and this approach is not also effective in moderate to severe periodontal lesions 4 – 6 .…”