Periimplantitis

Peri-implantitis: Symptoms, Causes and Treatment

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Peri-implantitis is a bacterial infection affecting the tissue and bone surrounding a dental implant. It is the leading cause of implant failure and, unlike tooth decay, develops silently — often without pain until significant bone loss has already occurred. Early detection and prompt treatment are essential to save the implant.

At Asensio Advanced Dentistry in Valencia, peri-implantitis is one of the most common reasons patients seek a second opinion or emergency consultation. This guide explains what it is, how to recognise it, what causes it and what can be done. For guidance on preventing it through correct daily cleaning, see our dental implant care guide.

What is peri-implantitis?

Peri-implantitis is an inflammatory condition affecting the soft tissue and bone around a dental implant, caused by bacterial biofilm accumulation. It is the implant equivalent of periodontitis — the gum disease that destroys the bone supporting natural teeth. Without treatment, peri-implantitis leads to progressive bone loss around the implant and ultimately to implant failure.

The condition develops in two stages. The first — peri-implant mucositis — affects only the soft tissue around the implant and is fully reversible with professional treatment and improved oral hygiene. If left untreated, mucositis progresses to peri-implantitis, which involves irreversible bone loss. This distinction is critical: peri-implant mucositis caught early can be resolved completely; established peri-implantitis requires more complex intervention and may not be fully reversible.

Symptoms of peri-implantitis

Many patients are unaware they have peri-implantitis because the early stages are often painless. The following signs should prompt an immediate professional assessment:

Symptom What it indicates
Redness or swelling of the gum around the implant Peri-implant mucositis — early stage, reversible
Bleeding when brushing or probing around the implant Active inflammation — requires professional assessment
Purulent discharge (pus) around the implant Active bacterial infection — urgent treatment needed
Persistent bad breath not resolved by brushing Bacterial accumulation around the implant
Pain when biting or clenching Possible bone loss or implant instability
Implant mobility Advanced peri-implantitis — significant bone loss

Causes and risk factors

Peri-implantitis is caused by bacteria — the same bacterial species responsible for periodontal disease in natural teeth. However, several factors increase the likelihood of developing the condition:

Risk factor Why it matters
Poor oral hygiene Allows biofilm to accumulate and harden around the implant
Smoking Impairs healing, reduces immune response, masks early symptoms
History of periodontitis Patients with previous gum disease are at significantly higher risk
Diabetes (uncontrolled) Impairs immune function and wound healing around implants
Poor implant quality or placement Suboptimal positioning creates areas where bacteria accumulate
Absence of regular professional reviews Early-stage disease goes undetected until significant damage has occurred

How peri-implantitis is diagnosed

Diagnosis requires a professional examination that includes probing around the implant to measure pocket depth, assessment of bleeding on probing, and radiographic imaging to evaluate bone levels. A single X-ray is insufficient — comparison with baseline images taken at implant placement is essential to identify bone loss that has occurred over time.

At Asensio, patients who present with symptoms of peri-implantitis receive a full diagnostic including digital periapical radiography and, where indicated, 3D CBCT imaging to assess the extent of bone involvement before any treatment is planned.

Treatment options

Treatment depends on the severity of the condition at the time of diagnosis. This is why early detection is so important — mucositis treated promptly resolves completely, whereas established peri-implantitis with significant bone loss requires more complex intervention:

Stage Treatment Outcome
Peri-implant mucositis Professional cleaning, improved oral hygiene protocol Fully reversible
Mild peri-implantitis Mechanical debridement, antiseptic treatment, surface decontamination Arrestable — bone loss does not progress
Moderate peri-implantitis Surgical access for deep cleaning, possible bone regeneration Partial bone recovery possible
Advanced peri-implantitis Implant removal, site treatment, possible re-implantation after healing Implant may not be salvageable

Frequently asked questions

Can peri-implantitis be cured?

Peri-implant mucositis — the early stage — is fully reversible with professional treatment and improved oral hygiene. Established peri-implantitis involving bone loss can be arrested but the bone loss itself is generally not fully reversible. This is why early detection is critical — the sooner treatment begins, the better the outcome.

How common is peri-implantitis?

Studies suggest that peri-implant mucositis affects around 43% of implant patients and peri-implantitis affects around 22% — making it the most common complication of dental implant treatment. The majority of cases are preventable with correct daily cleaning and regular professional reviews.

Does peri-implantitis mean my implant will fail?

Not necessarily. Implants diagnosed with peri-implantitis at an early or moderate stage can often be saved with appropriate treatment. Advanced cases with significant bone loss may require implant removal, but even then, re-implantation after treatment of the infection site is possible in many cases.

How can I prevent peri-implantitis?

Consistent daily cleaning with a soft toothbrush, interdental brush and water flosser removes the biofilm that causes the infection. Regular professional reviews every six months allow early-stage disease to be identified before bone loss occurs. Smoking cessation significantly reduces risk. See our guide to cleaning All-on-4 implants and our dental implant care guide for detailed advice.

I have symptoms of peri-implantitis — what should I do?

Contact us as soon as possible. Early intervention makes a significant difference to the outcome. Call us on 0800 048 8058, email office@dentalasensio.co.uk, or visit our dental implants abroad page. UK patients can send existing X-rays for a preliminary remote assessment before travelling.

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