Note: This article has a purely informative and educational role. It summarizes the different treatment options in the management of peri-implantitis. The article also gives a brief description of the etiopathogenesis, clinical features, and the diagnosis of peri-implantitis to help the implantologist in his/her treatment decision. This article should not be a source of remote diagnosis.
Risks of a dental implant
The installation of one or more dental implants involves risks. Like any dental, medical, and surgical intervention, zero risk does not exist. The objective of any dental surgeon is to minimize the risks thanks to a preoperative study which will list the factors increasing the risks during dental implant placement The patient must be informed of all the risks and dangers inherent in an implantology operation although it is never possible to list them all. Below you will find a non-exhaustive list of the risks and the means to avoid or treat them.
The main risks of dental implants
Peri-implantitis: Rejection of the dental implant
Peri-implantitis is the medical term for the infection that occurs around a dental implant. It is also called dental implant rejection. It occurs on traditional dental implants mainly because it is caused by bacteria finding on the rough surface of these implants an ideal place to develop. (The basal implant is made of smooth titanium, cases of peri-implantitis are non-existent). This infectious disease is characterized by inflammation of the peri-implant lining, bleeding and/or suppuration, and bone loss around the implant. It can be compared to periodontitis on natural teeth. Peri-implantitis is to be distinguished from peri-implant osteitis, which is due to older infections in the bone.
Dental implant infection
Peri-implant osteitis, more commonly referred to as dental implant infection, mainly occurs when bacteria are already present in the bone before the bone is placed. This infection is found mainly on dental implants. The basal implant is rarely affected by this type of infection thanks to its smooth surface and very small diameter. The infection and bacteria are naturally evacuated by following the surface of the implant without encountering any obstacle. With a traditional dental implant, bacteria are trapped in the bone tissue and mainly develop at the apex.
How to cure peri-implantitis or peri-implant osteitis
To date, there is no known effective treatment to cure peri-implantitis and infection around the dental implant. All attempts to clean and plan the implant are useless because new bacteria are formed constantly in the mouth. Some dentists attempt to polish the dental implant (instead of directly using a smooth implant) but the only benefit is slowing the development of infections. Polishing materials are difficult to remove and cause wounds and infections. In rare cases, the infection stops on its own: This phenomenon is observed mainly when the implant reaches more mineralized parts of the bone (cortical bone).
Today science agrees, there are no reliable therapies for peri-implantitis. To date, 2-phase implant removal is the only 100% safe way to avoid this. sickness.
Damage to the inferior dental nerve (NDI)
The dental nerve runs through the lower jaw. When placing a traditional implant, there is a risk of damage to this nerve when drilling with a large diameter. The results can be very inconvenient for the patient. Paralysis or loss of feeling on one side of the face, lips, and teeth. Sometimes the nerve may simply have been affected without being damaged. In this case, the loss of feeling is temporary.
Perforation of the sinus during the placement of the dental implant
Perforation of the sinus is rare and is not necessarily due to a bad act of the dentist. Bone tissue is not a flat surface but irregular and the nerve can sometimes have bifurcations. Drilling in traditional implantology is wide and the margin of error less important. Sinus perforation can be managed quite easily but requires several visits.
Our clinic no longer performs bone grafts. If the patient suffers from a lack of bone or if at least one complete jaw needs to be restored, he will be offered the basal implant
Extraction of a traditional dental implant
The extraction or removal of a traditional (classic) implant is a complex procedure that is performed only in the event that the dental implant experiences rejection or has become infected. This procedure results in a time of long healing and in most cases requires a bone graft. Indeed, the removal of the dental implant leads to a loss of significant bone volume. After the extraction or removal of a dental implant, there are 3 possible solutions:
- Placement of a removable prosthesis
- Bone grafting and placement of a new traditional implant
- Placement of basal implants (basals)
This last solution will only be viable if the entire jaw is to be treated in basal implantology.
