At the 2019 EAO Congress in Lisbon, experts Ignacio Sanz Sanchez and Jan Derks led a session on the treatment of peri-implantitis, a complex inflammatory disease affecting the tissues around dental implants. The prevalence of peri-implantitis is concerning, with studies indicating that around 22% of implant patients develop this condition, driven by various factors like systemic diseases, smoking, and previous implant failures. Understanding these risk factors is crucial for dental professionals when selecting suitable candidates for implants.
Sanz Sanchez discussed current treatment strategies, highlighting the importance of addressing the bacterial infection causing the inflammation and considering bone regeneration. The decision tree for treatment suggests that severe cases, where bone loss exceeds two-thirds of the implant length, may require implant extraction, while less severe cases might benefit from surgical decontamination and bone regeneration procedures.
Derks focused on regenerative approaches, stressing the role of implant surface properties and the importance of decontamination. His research indicates that smooth implant surfaces are more effective at resisting bacterial biofilm accumulation than rougher surfaces. Derks also highlighted the significance of soft tissue management and patient collaboration in maintaining implant health, particularly for aesthetic areas where soft tissue recession can be a concern.
Both experts agreed that prevention is key, with a growing emphasis on early intervention and personalized treatment protocols. Although current treatment options, like decontamination and bone grafting, show success rates around 80%, both speakers expressed hope for advances in molecular-level understanding and primary prevention strategies in the near future.
The session provided valuable insights for dental professionals, urging a more comprehensive approach to peri-implantitis, combining scientific research with practical clinical application. The discussion emphasized the need for further research, particularly in preventing the condition, improving patient outcomes, and refining surgical techniques.