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Peri-implantitis is a condition characterized by inflammation and bone loss in the soft tissue and bone around a dental implant. If left untreated, it can lead to implant failure. Treatment of peri-implantitis aims to control the inflammation, stop bone loss, and regenerate healthy tissues around the implant. Peri-implantitis treatment may include surgical and non-surgical approaches, depending on the severity of the disease.

Non-Surgical Treatments

In cases of early-stage peri-implantitis, non-surgical methods are generally preferred.

Professional Cleaning

• Mechanical cleaning with titanium or carbon fiber tipped instruments
• Plaque and tartar removal with ultrasonic devices
• Plastic or titanium curette tools are used to avoid damaging the implant surface

Antibiotic Treatment

• Local or systemic antibiotics are used to control inflammation
• Antibiotic gels or chlorhexidine solutions act as local antibiotics
• Systemic antibiotics include combinations such as amoxicillin and metronidazole

Laser Treatment

• Used to sterilize the implant surface and reduce bacterial load
• Minimally invasive and does not damage peri-implant tissues
• Speeds up the healing process

Chemical Decontamination

• Implant surface is cleaned with antimicrobial agents such as chlorhexidine, hydrogen peroxide, or citric acid
• Aims to reduce inflammation by removing bacteria

Surgical Treatments

Surgical methods are applied in advanced stages of peri-implantitis, where there is bone loss and deep pockets.

Surgical Flap Operation

• Performed under local anesthesia
• Gum tissue is lifted to expose the implant
• Infected soft and bone tissue is removed
• Implant surface is decontaminated
• Gum tissue is sutured back in place

Resective Surgery

• Correction of bone and soft tissues deformed due to peri-implantitis
• Aims to reshape bone edges and remove infected tissues

Guided Tissue Regeneration (GTR)

• Bone grafts (synthetic, autograft, or allograft) are applied around the implant
• Barrier membranes are used to stabilize the graft
• Promotes bone regeneration and implant stability

Implant Surrounding Soft Tissue Treatment

• Grafting procedures to increase soft tissue thickness or improve gum health
• Connective tissue grafts from the palate are used for peri-implant stability

Combined Treatment Approaches

Surgical and non-surgical treatments can be used together.

• Flap surgery can be performed after mechanical cleaning, chemical decontamination, and antibiotic treatment
• Laser treatment and bone graft applications can be combined

Post-Treatment Care

The success of peri-implantitis treatment depends on regular oral hygiene and dentist check-ups.

Postoperative Recommendations

• Oral hygiene education: Correct brushing, interdental brush use, and mouthwash
• Check-ups: Regular evaluations of healing and implant tissue stability
• Regular professional cleaning of the implant area

New Technologies Used in Treatment

Photodynamic Therapy (PDT)

• Light-sensitive substance is applied and bacteria are killed with laser
• Non-invasive method for sterilizing infected tissues

Piezo Surgery

• Used in sensitive surgical procedures to avoid damaging bone tissue

Factors Affecting Treatment Success

• Patient’s oral hygiene habits
• Early intervention increases success
• Condition of the implant surface
• Regular periodontal support and check-ups

Conclusion

Peri-implantitis treatment can be managed successfully with early detection of the disease and application of appropriate methods. Not neglecting regular check-ups after treatment, paying attention to oral hygiene, and following the doctor’s recommendations ensure the longevity of the implant. Therefore, a multidisciplinary approach is important in the prevention and treatment of peri-implantitis.