Η περιεμφυτευματίτιδα είναι φλεγμονώδης νόσος, η οποία συνεπάγεται την απώλεια στηρικτικού οστού που περιβάλλει ένα εμφύτευμα, το οποίο έχει ήδη οστεοενσωματωθεί και βρίσκεται σε λειτουργία στο στόμα. Αρχικά ξεκινά με τη μορφή μιας ήπιας φλεγμονής, η οποία περιορίζεται στους μαλακούς ιστούς γύρω από το εμφύτευμα και θεωρείται κατάσταση αναστρέψιμη με την κατάλληλη θεραπεία.
Etiology and symptoms
The response of the gingiva and peri-implant mucosa to microbial plaque formation has been extensively analysed in preclinical and clinical studies. The clinical features of peri-implant mucositis, similar to those gingivitis at teeth include classical symptoms of inflammation, namely swelling and redness.
Peri-implantitis represents a clinical condition that combines inflammation at the peri-implant mucosa and loss of supporting bone. The diagnosis of peri-implantitis is based on the combination of clinical and radiographic examination. It initially affects the most marginal part of the implant and gradually, if remains untreated ultimately results in complete loss of osseointegration.
Implant mobility is not an essential symptom for peri‐implantitis, but may occur in the final stage of disease progression and bone loss. The clinical signs of peri‐implantitis may vary and may not always be associated with overt signs of pathology.
Treatment strategies
The selection of the treatment approach is based on the diagnosis and the severity of the disease. In all forms of peri‐implant disease, the treatment strategy must include mechanical cleaning (infection control) and instruction on the use of oral hygiene measures. The patient must also be provided professional mechanical cleaning, including removal of plaque and calculus from implant surfaces. It is important the design of the prosthetic reconstruction to allow access for optimal brushing and flossing.
Peri-implant mucositis and initial stages of peri-implantitis may be treated with non-surgical debridement of implant surfaces with titanium‐coated or carbon‐fiber curettes, rubber cups and a polishing paste. The incorporation of laser devices is also an effective therapeutic tool for initial form of peri-implantitis.
Severe forms of peri-implantitis are treated with surgical approach with aim to acquire access to the implant surface for debridement and decontamination, in order to achieve resolution of the inflammatory lesion.
