What is Peri-Implantitis? Symptoms, Causes, Treatment, and Prevention of Peri-Implantitis

by Dental-Pedia
What is Peri-Implantitis? Symptoms, Causes, Treatment, and Prevention of Peri-Implantitis

Peri-implantitis is an inflammatory condition that affects patients with dental implants, especially titanium implants. Peri-implantitis starts as bacteria forms in and around the implant and gum tissues. The symptoms are similar to gum disease, and just like gum disease, peri-implantitis also affects the gums and surrounding teeth. 

However, peri-implantitis is a rare condition that occurs in a minor subset of patients (5% to 8%) with dental implants. In the early stages, the symptoms of peri-implantitis are relatively mild, such as redness, swelling, gum bleeding, etc. If caught at an early stage, peri-implantitis is easily treatable. However, if left untreated, the symptoms may worsen and cause implant failure. 

Peri-implantitis may occur due to various reasons, such as improper surgical techniques, improper bite distribution, inadequate oral hygiene, or bacterial accumulation caused by micro-gaps in the implant. According to recent studies, over 40% of dental implants have a risk of peri-implantitis after five years, which means patients with titanium implants must go for regular dental checkups. 

This article investigates the importance of soft-tissue adaptation (biointegration) for dental implants, oral health, and overall health. We also discuss how zirconia implants are better capable of ensuring soft-tissue adaptation than titanium implants. 

Symptoms of Peri-Implantitis

  • Redness and swelling around the implant site 
  • Receding gum line — the pocket of space around the gum grows larger 
  • Implant visibility around the gum line 
  • Metallic taste in the mouth 
  • Pus-filled cysts around the implant site 
  • Bleeding while brushing 
  • Swollen lymph nodes 
  • Aching sensations around the implant site 
  • Loosening implant 
  • Soreness in the jaw muscles due to deteriorating bone tissues 
Causes of Peri-Implantitis

Causes of Peri-Implantitis 

Compromised Immunity: Patients with compromised immune systems due to diabetes or other illnesses have a higher risk of peri-implantitis. Furthermore, patients with a history of gum disease or periodontitis also have higher risks of peri-implantitis and inflammation around the implant. 

Inadequate Oral Hygiene:

Inadequate Oral Hygiene: Peri-implantitis usually occurs when food particles accumulate around the implant site, leading to bacteria and plaque adhesion. The accumulation of plaque and tartar leads to bacterial infections, instigating peri-implantitis. As such, you must maintain optimal oral hygiene, brush and floss regularly, and go for regular dental cleanings to avoid peri-implantitis. 

Lifestyle Factors:

Patients who smoke, drink frequently, or consume drugs are more likely to experience peri-implantitis. That’s because smoking, drinking, and drug use compromise the immune system, slow down the body’s healing and defense mechanisms, leading to a high risk of bacterial infections.

Parafunctional Habits: 

Involuntary habits and bodily movements, such as nail-biting, improperly positioned teeth and jaws, teeth grinding, etc., can loosen the implant, create space for bacterial accumulation, and cause peri-implantitis.

Implant Structure/ Material:

Titanium implants have a higher risk of peri-implantitis than ceramic (zirconium) implants. That’s because bacteria adhere to the titanium surface with greater ease, and the micro-gaps between the implant and abutment can also serve as grounds for bacterial accumulation, leading to peri-implantitis.

Treatments for Peri-Implantitis 


Oral or topical antibiotics can control mild-to-moderate gum infections caused by peri-implantitis.


The doctor will clean the implant surface using titanium brushes, ultrasonic devices, curettes, and air abrasion, removing all the bacterial plaque and tartar.

Laser Therapy:

 As a non-surgical option, laser devices can emit laser energy to kill the bacteria responsible for gum infection around the implant.


 If you have advanced peri-implantitis, the surgeon may pull back the gum flaps around the implant to remove the infected tissues, plaque, and bacteria. Bone grafting may be necessary to restore optimal bone levels.


 The infected or damaged implant has to be removed if all other methods fail. However, after the infection is treated, the dental surgeon may perform bone grafting and another dental implant procedure.
How to Prevent Peri-Implantitis?

How to Prevent Peri-Implantitis? 

#1. Optimal Oral Hygiene 

Peri-implantitis usually occurs due to improper oral hygiene, which leads to bacterial accumulation at the implant site. As such, the best way to prevent peri-implant complications is to maintain optimal oral hygiene. You should brush and floss twice a day, use water flossers and other oral hygiene aids, and go for regular dental cleaning and check-ups. 

#2. Lifestyle Changes 

The risk of peri-implantitis increases if you consume tobacco, alcohol, or drugs. These lifestyle habits compromise your immune system, reduce the speed of healing, thereby leading to a higher risk of infections. Furthermore, you should also control parafunctional habits that occur without conscious awareness, such as nail-biting and teeth grinding. Please talk to your dentist about solutions for your teeth grinding problems. 

#3. Zirconia Implants 

Titanium implants have been the gold standard in dental implantology for decades. However, thanks to recent innovations, zirconia implants may be a better alternative, minimizing the risk of peri-implantitis. Titanium implants have a higher risk of peri-implantitis because bacteria adhere to the implant surface with greater ease, and the micro-gaps between the implant and abutment can host bacteria. 

Zirconia implants, however, minimize the risk of peri-implantitis. That’s because bacteria doesn’t adhere to the zirconia surface as easily, and most zirconia implants have cemented connections without screws, so there are no micro-gaps where bacteria may accumulate. Furthermore, recent studies have shown that zirconia implants have similar success rates as titanium implants, making them the ideal alternatives. 

If you’re concerned about peri-implantitis after implant surgery, please talk to your dentist about your ceramic implant options. 

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Perfect Soft-Tissue Adaptation: The Secret Ingredient for Lifelong Healthy Dental Implants
by Dental-Pedia

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