Peri-implantitis. Part 3: Current modes of management

Abstract

Peri-implantitis is an inflammatory condition fuelled by the presence of bacteria on the implant surface. As such, in a similar manner to periodontal disease management, the removal of biofilm from the implant surface should result in regression of the disease process. The optimal manner with which this is achieved has yet to be realised. This may be unsurprising due to the relative surface complexity of the implant surface when compared to natural tooth root. Other management strategies include surface decontamination, the removal of implant threads known as implantoplasty, and in severe cases the need to explant. Favourable defects can be reconstructed utilising guided bone regeneration techniques. The current review appraises some of the techniques for the management of peri-implantitis.

Development of a peri‐implantitis model in the rat

“…The detection of putative pathogens may indicate a high risk of the occurrence of these diseases and need relative interventions. Moreover, antimicrobial application has been reported as successful adjunctive treatment in peri‐implantitis therapy (Alani & Bishop, ; Renvert, Lessem, Dahlen, Renvert, & Lindahl, ; Salvi, Persson, Heitz‐Mayfield, Frei, & Lang, ). In view of the results in this study, antibiotic treatment also might be considered as an effective approach for the prevention of peri‐implantitis.…”

In vitro evaluation of the antibiofilm properties of chlorhexidine and delmopinol on dental implant surfaces

“…This provides an opportunity to eradicate biofilms accumulated on these components when removed from the mouth, usually by physical and chemical means. Scaling of the implant with plastic or Teflon-coated scalers, use of lasers, through to implantoplasty (which involves removal of the threads on the implant), are physical methods often employed [5]. There are numerous chemical forms of disinfection used for chemical decontamination, including hydrogen peroxide, citric acid, sodium hypochlorite and chlorhexidine gels [5,6]; however, standard protocols are yet to be established.…”

Osteoblast growth, after cleaning of biofilm‐covered titanium discs with air‐polishing and cold plasma

“…The cornerstone of any peri‐implantitis therapy comprises mechanical removal of the biofilm (Alani & Bishop, ), which should not change the micromorphology of the implant surface in order to conserve the advanced surface properties for re‐osseointegration (Wennerberg et al., ). Additionally, a surface‐abrasive mechanical treatment can spread foreign particles into the surrounding tissue (Sahrmann et al., ), which can hamper the cell attachment or promote inflammation process (Albrektsson et al., ).…”