The treatment aims to stop the progression of infection and to maintain the implant. It starts with an accurate diagnosis based on X-ray imaging to determine any possible bone loss. Then periodontal probing will determine the stage of infection and a treatment plan will be recommended which include a combination of the following methods:
They are the first line of defense against any infection that might include pills or prescription-strength mouth rinse. Sometimes antimicrobial therapies are prescribed for infections caused by other microbes.
This method is appropriate for shallow mucosal pockets where a carbon fiber curette or an ultrasonic device is used. Also known as submucosal debridement, the high-frequency waves clean the infected area around the implant.
In the case of deep mucosal pockets which are more than 5mm, mechanical flossing or delicate scaling instruments are used to clean the contamination without damage to the surface of the rod. Localized antiseptics are often used after mechanical removal of the infection.
A surgical method or open flap debridement is utilized when access to infection site is not possible so a flap of gum is opened. According to the need, mechanical debridement and antiseptics are also combined.
Laser surface decontamination
This is a recent approach where laser beams are used to remove contamination from the surface of the titanium implant and surrounding tissues. The pulse settings are adjusted according to the level of peri-implantitis.
This is the worst-case scenario when the level of infection is severe and bone loss is significant which often happens when peri-implant mucositis develops into deep peri-implantitis. Surgical instruments such as a trephine or a forceps are often used for this procedure.
After several months of healing and bone grafts, reimplantation might be an option.