Direct answer

Peri-implant mucositis is inflammation in the soft tissue around an implant, commonly identified by bleeding on gentle probing. Peri-implantitis combines peri-implant inflammation with progressive supporting bone loss. Both can occur around ceramic implants; current clinical evidence does not show that zirconia makes an implant immune to peri-implant disease.

Key takeaways

  • Dental plaque is the primary cause of peri-implant inflammatory disease.
  • Mucositis can often be controlled before supporting bone is progressively lost.
  • Peri-implantitis may develop with little pain, so monitoring matters.
  • Baseline probing and radiographs make change easier to identify.

Mucositis and peri-implantitis are different

Mucositis is inflammation confined to the soft tissues and is characterized clinically by bleeding and sometimes suppuration on gentle probing. Peri-implantitis includes inflammation plus progressive bone loss after initial healing. Diagnosis uses the clinical examination, radiographs, and comparison with earlier records where available.

Signs that deserve assessment

Bleeding during professional probing, swelling, redness, drainage, deeper probing measurements, recession, visible threads, progressive radiographic bone change, or implant mobility can be important. Pain may be absent. Mobility can indicate loss of integration and requires prompt evaluation.

Risk control and prevention

  • Treat periodontitis and reach stable periodontal health before implant placement.
  • Design a restoration that the patient and clinical team can clean and examine.
  • Use effective daily plaque control and risk-based supportive care.
  • Address smoking, glycemic control, and other modifiable risks.
  • Monitor probing, bleeding, tissue levels, and radiographs over time.

What treatment may involve

Treatment starts with diagnosis, plaque control, professional decontamination, correction of cleanability problems when possible, and risk-factor management. Persistent peri-implantitis may require surgical access or reconstructive or resective approaches. The plan depends on defect anatomy, implant position and surface, restoration, patient factors, and response to initial care.

Selected references

  1. Berglundh T, et al. Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop. Journal of Periodontology. 2018. doi:10.1002/JPER.17-0739.
  2. Herrera D, et al. Prevention and treatment of peri-implant diseases—The EFP S3 level clinical practice guideline. Journal of Clinical Periodontology. 2023. doi:10.1111/jcpe.13823.