Peri-implantitis is a destructive inflammatory process affecting both soft and hard tissue surrounding an osseointegrated dental implant in function. Similar to a natural tooth, bacteria can build up on the base of the implant, below the gum line. Over time, the bacteria irritate the gum tissue, causing it to become inflamed, damaging the tissue and if not caught early, causing the bone structure below the implant to deteriorate.
Peri-implant diseases are classified into two categories.
Peri-implant mucositis - gum inflammation only around the soft tissues of the dental implant, with no signs of bone loss. Generally peri-implant mucositis is a precursor to peri-implantitis.
Peri-implantitis - gum inflammation is found around the soft tissue and there is deterioration in the bone supporting the dental implant.
In this case, the peri-implantitis caused lots of pain and bleeding when brushing. The picture showed that abscess formed with red or tender gums around the implants. On the x-ray, lots of subgingival calculus buildup. The two implant supported crowns were fused together, which made flossing extremely difficult. The design of the crowns made oral hygiene around implants very hard to maintain.
Treatment: drain the pus, remove subgingival calculus, scale and clean the area, irrigate with anti-septic solution and antibiotics.
The peri-implantitis may recur due to the difficulty of maintenance. Two individual implant supported crowns are preferred.