Monday, December 2, 2013

Periodontitis & Peri-Implantitis - What's the Difference?

Peri-Implantitis over 5 yrs in smoker. ( Source: Wikipedia)

Replacement of missing teeth with implant supported restorations has become increasingly common. While implant supported restorations do not share the risk of dental caries that natural teeth are subject to, they are susceptible to peri-implant mucositis and peri-implantitis, just as the natural dentition is subject to gingivitis and periodontitis. It is well established that periodic periodontal maintenance can optimize the long-term prognosis of the natural dentition. Like-wise, successful dental implant therapy must include an appropriate recall program. A major etiologic factor in periodontitis is the formation of a biofilm harboring pathogenic bacteria, and this is also true for peri-implantitis. Bacterial colonization of implant abutments has been found to be similar on both zirconia and titanium abutments.
Peri-implantitis is defined as an inflammatory process affecting the tissues around an osseointegrated implant in function, resulting in loss of supporting bone. Peri-implant mucositis is defined as reversible inflammatory changes of the peri-implant soft tissues in the absence of bone loss. The prevalence of peri-implantitis has been reported to be as low as approximately 10% to as high as 47%; the prevalence of peri-implant mucositis is generally greater, ranging from 32% to 80%.
Periodontal and peri-implant bone turnover is a balanced dynamic process that involves resorption and formation, controlled and influenced by the local production of cytokines, with a wide range of inflammatory, hemopoietic, metabolic and immunomodulatory properties. Peri-implant microbial contamination or infection (bacteria and viruses) elicit an immune response regulated by key cytokines (TNF-a, Interleukin [IL]-1ß, TGF- ß, IL-10) that control the progression and/or suppression of the inflammatory response. Over-production of pro-inflammatory cytokines, released by monocytes / macrophages and T cells in response to a microbial challenge can lead to the breakdown of the periodontal or peri-implant tissues.
The continuous balance that exists between the host immune response and potential subgingival pathogens (bacteria / viruses) determines the clinical condition, not only around teeth, but also around osseointegrated dental implants. On February 21st, at the Nowzari Symposium, peri-implantitis will be discussed by Drs. Tord Berglundh and Hessam Nowzari:


Rubino Dentistry said...

What do you propose for a good periodontal maintenance program? This has been a hot issue in my Park Ridge dental office in regards to dental implants.

Unknown said...

Yes, most people consider cost prior deciding to get dental implants. But the cost of course depends on the dentist and the area where you are undergoing the procedure. Cost is the only downside of the procedure. But they are the right choice for people of any age with lost or damaged teeth. These are the long-term and permanent solution for removable dentures. They simply look like your natural teeth and replacing your lost teeth with implants can help to retain your natural face shape and smile. But make sure to consult a specialized dentist before going to get any kind of dental procedure.

Sarah said...

I am only aware with replacement of missing teeth. But I am not familiar with the risk after having implant restorations. After seeing the photo, it makes me feel relieved that I am not smoking because pre-implantitis seems alarming to see and to feel. I wonder what are the necessary things to do to prevent this.

Unknown said...

I would like to thanks for sharing sharing such a nice information.