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Treatment guidelines

Inflammation and infection

Key points

  • Mucositis and Peri-implantitis treatments focus on elimination of pathogenic biofilm and removal of causal or supporting factors such as subgingival cement remnants, restoration cleansability, hygiene etc.
  • Typical antimicrobials are 0.2 % Chlorhexidine, and adjunctive therapy options with antibiotics
  • Consider increasing recall frequency and hygiene instructions to patient
  • Adjunctive antimicrobial therapy options such as laser or ATP do not provide evidence-based or increased efficiency and efficacy

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Additional resources

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Videos

Chandur Wadhwani: Implants, cement and peri-implantitis - science and the missing link

Cementation procedures and materials have been reported to cause complications in implant prosthetics, mainly inflammation around the implant due to cement material excess. Cementation procedures are a complex system, not all the dimensions of which seem to be fully understood and...
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Andrea Mombelli: Peri-implant anti-infective therapy

Peri-implantitis is an infection around implants associated with the presence of submucosal bacterial biofilm, with the biofilm microorganisms adhering and hiding on irregular surface structures such as the rough implant surface, crown margin areas and unfavorably designed...
Peri-implantitis
Aftercare / follow up
Peri-implant therapy
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Marco Esposito: Light activated disinfection in the case of peri-implantitis

Treatment objective of a chronic disinfection is to reduce bacterial load under a critical threshold. In the case of peri-implant infections the measures to reduce bacterial contamination can comprise e.g. surgical or non-surgical debridement and implant surface decontamination...
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David Chvartszaid: Distinction between normality and pathology of marginal bone around oral implants

Distinguishing normal and abnormal marginal bone behaviour around osseointegrated implants is a complex and controversial topic. Dr Chvartszaid reviews why this distinction is difficult, and discusses topics such as the existence of multiple proposed etiologies, deficiencies in...
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Sreenivas Koka: Assessment of bone quality relevant for marginal bone integrity ?

The lecture discusses in how far the assessment of marginal bone can be a suitable measure for bone integrity and implant oesseointegration. Dr Koka reviews aspects of definition of bone quality and the concept of osseo-sufficiency, and shows that we still are influenced by biases...
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