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Dental Implant Infections

Infections of the implantation area is the most common of the dental implant complications. Implant infection is a condition referred as peri-implantitis which is characterized by inflammation or swelling of the tissues surrounding the implantation area. Peri-implantitis is a form of periodontal disease that can lead to inflammation, bone loss and dental implant failure if not treated properly.   Causes | Symptoms | Prevention | Treatment

Causes of dental implant infection (peri-implantitis)

Although implant infections are usually caused by the presence of bacteria during or immediately after the oral surgery for the placement of the implant, an implant infection can happen months or years after surgery.

Implant complications related to implant infection can be caused by:

  • Poor sterilization - if the dentist does not follow carefully the proper sterilization procedures, a contaminated tool may infect the surgical site with bacteria during the insertion of the fixture causing peri-implantitis.
  • Dental implant contamination - dental implants are provided in sterile packaging but they can be contaminated during the procedure.
  • Poor material quality - low quality implants may not fit precisely leaving a gap between the fixture and the bone that could attract bacteria and get infected.
  • Improper implant placement - an improperly placed dental implant may also leave some space between the fixture and the bone that could allow bacteria to invade and infect it. Premature loading, leading to bone micro-fractures that may trap bacteria, is another potential cause of peri implantitis.
  • Restoration problems - if the crown placed on the dental implant is oversized or has an abnormal contour putting pressure to gingival tissues, it can lead to inflammation and infection.
  • Poor oral hygiene - if the patient does not follow the dentist's advice and oral hygiene instructions after the surgery, the accumulation of dental plaque can cause implant infection. Poor oral hygiene is one of the main causes of late implant failure due to infection even years later.

Bacteria can infect the jawbone around the implant either directly if they can enter between the implant and bone, or by first infecting the surrounding gum tissues.

Symptoms of infected dental implant

The most common symptom of an infected dental implant is the inflammation and swelling of the surrounding tissues. Dental implant inflammation triggers a response from the body's immune system that attacks the infected gingival and bone cells. This can result to bone loss around the implant and if it continues the implant will become loose and will have to be removed.

Inflammation may be caused by other causes such as improper placement of the implant, but in any case it is advised that you visit your implant dentist with the first sign of swelling.

The formation of a fistula close to the implant followed by pus drainage in the mouth is a clear sign of peri-implantitis which requires immediate treatment.

Prevention of dental implant infections

The following instructions can help to prevent the development of a dental implant infection:
  • Pre-emptive prescription of antibiotics for some days prior to surgery can help reduce the risk of implant infection.
  • Sterile environment during the implant surgery is necessary for avoiding surgery infections.
  • After surgery, most implant dentists will prescribe antibiotics and recommend the use of an antibacterial mouthwash.
  • Patients must maintain proper daily oral hygiene (brushing and flossing) in combination with preventive visits to the dentist and periodic dental cleanings.
  • Smoking should be avoided because it delays healing and increases the risk of infections.
  • For patients of high risk groups, the implant dentist may recommend periodic x-rays to help diagnose and treat any problem of implant infection as soon as possible.

Treatment of dental implant infection

The most important part of peri-implantitis treatment is to find and treat the cause of the dental implant infection. The dentist will normally clean the area and prescribe antibiotics to fight the infection but if the cause of the infection is not treated the problem will appear again after the patient stops the antibiotics.

An inflammation caused by a trauma due to improper crown size or shape, can be treated by removing the abnormal crown restoration. After the inflammation has subsided, a proper crown can be placed on the dental implant to restore the tooth.

If the implant infection was caused due to poor oral hygiene, professional dental cleaning and debridement, antibiotics and careful brushing and flossing are usually enough to treat the condition. But if the cause of dental implant infection is a loose implant (due to poor material or improper placement) that allows bacteria to invade between the fixture and the bone, the only way to stop the infection and prevent further damage to the jawbone is to remove the loose implant.

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Last update: 03/03/2014