Treatment

A dental implant showing signs of failure doesn't always need to be removed. With early diagnosis and the right care, you may be able to save it.​

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1. Peri-Implant Mucositis (Reversible Soft Tissue Inflammation)

 Treatment Approach:​​

• Phase-contrast microscopy to educate and personalize care

• Biofilm DNA test to identify pathogens

• Mechanical debridement with plastic, titanium, or PEEK scalers

• Air polishing with glycine or erythritol powders

• Antimicrobial agents:

  • Ozone water, Molecular Iodine

  • Local antibiotic delivery (e.g., minocycline microspheres)

• Laser therapy (e.g., diode or Nd:YAG) – bactericidal and biostimulatory

• Improved oral hygiene education

• Prebiotics

• Maintenance recall every 3–4 months

• Prognosis: Good, especially with early intervention​

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2. Peri-Implantitis (Bone Loss + Infection) Non-Surgical Options (Early to Moderate Cases):

• Same as mucositis plus:

  • Systemic antibiotics in some cases (e.g., amoxicillin + metronidazole)

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 Surgical Treatment (Moderate to Severe Bone Loss):​

• Open flap debridement to access contaminated surfaces

• Decontamination of the implant surface (laser, chemical, mechanical)

• Bone grafting/regeneration if the defect is favorable

  • Use of growth factors (e.g., EMD, PRF)

• Resective therapy (implantoplasty) in non-regenerative defects

•  Prognosis: Variable, depends on the amount of bone loss, the implant surface, and maintenance

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 3. Mechanical Failures (e.g., loose abutment, fractured screw, broken implant) Treatment: Replace or tighten loose components

• Remove fractured screws (using kits or ultrasonic scalers)

• If the implant fractured below the bone → explantation is often required

      Prognosis: If prosthetic components are replaced and occlusion is adjusted, implant can often be saved.

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​ 4. Implant Explantation (When Salvage Is Not Possible) Indications:​

• 50% bone loss with mobility

• Non-responsive to therapy

• Implant fracture

• Severe infection or pain​​

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​ Techniques:​

• Reverse torque removal (atraumatic)

• Trephine bur if osseointegrated

• Socket grafting may be performed to preserve bone

• After healing (typically 4–6 months), options include:

• New implant (possibly guided bone regeneration first)

• Fixed/removable prosthesis

• Leaving the site edentulous (if esthetically and functionally acceptable)

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 5. Supportive Maintenance Therapy​

 Long-term strategies:​

• Prebiotics

• Regular Salivary Testing ( Microscopy and lab test)

• Regular professional cleanings (every 3–4 months)

• Customized home care protocols (brushes, water flossers, rinses)

• Splinting of prostheses if bruxism is present

• Occlusal guard for night-time wear