Peri-implantitis is a bacterial infection of the tissues around a dental implant that, if untreated, progressively destroys the bone supporting the implant. It is the implant-dentistry equivalent of periodontal disease, and the leading cause of late implant failure. Early detection changes the prognosis dramatically.

Peri-Implant Mucositis vs. Peri-Implantitis

Peri-implant mucositis — inflammation of the soft tissue only, no bone loss. Fully reversible with treatment.
Peri-implantitis — inflammation plus bone loss around the implant. Not fully reversible; the goal is stopping progression.

Symptoms to Watch For

Bleeding when brushing or flossing around the implant
Red, swollen, or tender gum tissue
Pus or foul taste
Gum recession exposing the implant threads or abutment
Visible loosening of the crown or bridge
Deep pocket formation on probing

How We Diagnose It

Diagnosis combines clinical measurements and imaging:

Probing depth measurements around each implant (2-4 mm is healthy; deeper indicates concern)
Bleeding on probing — the most sensitive early indicator
Periapical radiographs to measure bone loss from the implant shoulder
CBCT imaging for complex cases or 3D assessment of bone defects
Mobility testing (mobility means advanced failure)

Treatment Approach

Non-Surgical Phase

Professional mechanical debridement of the implant surface using specialized instruments (titanium or plastic curettes, air polishing with glycine or erythritol powder, ultrasonic scalers with appropriate tips). Adjunctive antimicrobial therapy may be used.

Surgical Phase (if non-surgical fails)

Open-flap debridement — surgical access to decontaminate the implant surface
Regenerative therapy — bone grafting and membrane placement to rebuild lost bone, where defect anatomy allows
Resective therapy — reshaping the bone to eliminate pockets (sacrifices some bone to gain cleanability)
Implant removal and site regeneration — when the implant is no longer salvageable

Prevention

Professional maintenance every 3-4 months for implant patients (not 6)
Meticulous daily home care — brushing, water flosser, interdental aids
Smoking cessation
Blood glucose control for diabetic patients
Correction of any overloaded occlusion or excessive cantilevers
Regular 360° radiographic assessment annually

If you notice any of the warning signs around an implant — especially bleeding or gum recession — contact us for an implant evaluation.

Request a consultation to discuss your case.

Serving Patients Across Greater Boston

The Face Dental Group welcomes patients from throughout Greater Boston:

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