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<p>Dental implants have high, well-documented survival rates. However, these are also offset by complications during the functional period. Peri-implantitis, a&#xa0;biofilm-induced inflammatory reaction of the peri-implant hard and soft tissues, is an increasing problem with a&#xa0;prevalence of approximately 20% of implants. The treatment of peri-implantitis involves a&#xa0;step-by-step approach consisting of conservative treatment, surgical treatment, and structured aftercare. As conservative treatment measures are less successful, surgical therapy appears to be more effective. Hereby, a&#xa0;distinction is made between access flap surgery, resective procedures, and reconstructive surgery. Decontamination of the implant surface is a&#xa0;central component of the surgical phase. At present, no one type of decontamination appears to be superior, with the use of titanium brushes appearing promising. Adjunctive soft tissue surgery can improve treatment results in cases of inadequate keratinized mucosa. Further decisions need to be made for reconstructive therapies: What is the best way to augment the defect? Is a&#xa0;membrane application appropriate? Should submerged or open healing be favored? All three interventions lead to an improvement in clinical and, in some cases, radiological parameters, but they also show a&#xa0;high risk of recurrence or progression. For this reason, it is important to include the patient in a&#xa0;structured supportive peri-implant care (SPIC) program. A&#xa0;lack of or inadequate SPIC is associated with a&#xa0;greatly increased risk of recurrence and implant loss.</p>

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Chirurgische Therapie der Periimplantitis

  • 期刊论文

  • 发表日期：

    2025年4月7日

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  • Sebastian Becher

摘要

Dental implants have high, well-documented survival rates. However, these are also offset by complications during the functional period. Peri-implantitis, a biofilm-induced inflammatory reaction of the peri-implant hard and soft tissues, is an increasing problem with a prevalence of approximately 20% of implants. The treatment of peri-implantitis involves a step-by-step approach consisting of conservative treatment, surgical treatment, and structured aftercare. As conservative treatment measures are less successful, surgical therapy appears to be more effective. Hereby, a distinction is made between access flap surgery, resective procedures, and reconstructive surgery. Decontamination of the implant surface is a central component of the surgical phase. At present, no one type of decontamination appears to be superior, with the use of titanium brushes appearing promising. Adjunctive soft tissue surgery can improve treatment results in cases of inadequate keratinized mucosa. Further decisions need to be made for reconstructive therapies: What is the best way to augment the defect? Is a membrane application appropriate? Should submerged or open healing be favored? All three interventions lead to an improvement in clinical and, in some cases, radiological parameters, but they also show a high risk of recurrence or progression. For this reason, it is important to include the patient in a structured supportive peri-implant care (SPIC) program. A lack of or inadequate SPIC is associated with a greatly increased risk of recurrence and implant loss.