Peri-implantitis: an Unusual Presentation

From Volume 47, Issue 2, February 2020 | Pages 115-120

Authors

Craig W Barclay

BDS, FDS RCPS, DRD RCS, MRD RCS, MPhil, PhD, FDS RCPS(Rest)

Consultant in Restorative Dentistry/Hon Senior Lecturer, Central Manchester Dental Hospital, Manchester

Articles by Craig W Barclay

Emma Foster-Thomas

Academic Clinical Fellow in Restorative Dentistry, University Dental Hospital of Manchester

Articles by Emma Foster-Thomas

Abstract

Rehabilitation with dental implants is not without post-placement complications, one of which is peri-implantitis. Peri-implantitis is a progressive inflammatory disease which affects the hard and soft tissues around a dental implant. The consequent bone resorption and reduced osseointegration significantly affects the long-term viability of the implant fixture. Without treatment, peri-implantitis can progress in an accelerating, non-linear pattern.

The aetiology of peri-implantitis is debated in the literature. Consequently, over the last ten years there have been numerous consensus meetings debating this topic and various guidelines have been written and updated by experts in the field. There is extensive, sometimes conflicting, literature on the subject in the scientific journals. The aetiological factors involved and the management of the condition remains up for debate…

In 2011, a new patient attended the University Dental Hospital of Manchester with nine Xive implants (Dentsply Sirona), four maxillary and five mandibular. For various reasons the maxillary implants were all restored, however, only three of the mandibular implants were restored and two were left buried. In 2016, the patient returned with signs and symptoms of peri-implantitis around the most mesial buried implant (LL6 region). The potential reasons why this may have occurred were investigated and forms this case report.

CPD/Clinical Relevance: Peri-implantitis may be associated with apparently buried implants.

Article

Osseointegration is considered a prerequisite for the long-term clinical success of dental implants. Osseointegration of a dental implant can be defined as the continuing structural and functional coexistence between living bone and the surface of a load-bearing implant.1 Clinically, an implant can be regarded as osseointegrated when there is no relative movement between the implant and the bone in direct contact during functional loading, therefore, the implant fixture provides stable support for the prostheses.

There remains a lack of agreement in the dental implant literature with regards to the definition of implant success. Albrektsson et al proposed the commonly accepted criteria for the assessment of implant success at the implant level,2 including implant immobility, less than 0.2 mm vertical bone loss annually following the first year, and absence of pain, infection, or peri-implant radiolucencies. A systematic review identified frequently used parameters for assessing implant success, specifically, success at the implant level, peri-implant soft tissue, prosthetics and patient evaluation.3

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