Gum Diease

This morning’s BBC News article ‘Dentists warn of risks of not looking after implants’ was a topic for discussion at the practice this morning.
Dawood & Tanner Dental Implant treatments are very successful and rarely fail. However, many patients are referred to us with implant problems for advice, treatment, or re-treatment.…/dental-implants/dental-…/

Implant treatments are a lifelong commitment, it is important to also consider the potential for short-term failure or longer-term problems. 
For an implant to be used to support a dental restoration it needs to osseointegrate; this means that living bone must actually grow on to the surface of the implant. Ideally, the implant needs to be well anchored in good quality healthy bone, in a healthy patient and without heavy biting forces.

Peri-implantitis is an issue which is becoming more common, simply because we see at the practice more and more patients who have been treated with dental implants over the years.
In many respects there are similarities with periodontal (gum) diseas earound teeth. The first sign of a problem may be soreness or bleeding from the gum – ‘mucositis’. Treatment at this stage may prevent progression to peri-implantitis, when progressive bone loss starts to become an issue, and can ultimately lead to catastrophic loss of the supporting bone as well as the implant or implants.
In our practice we only use of titanium or zirconium abutment connectors to connect the implant tooth to the implant 'screw'. These are exceptionally biocompatible materials, which tend to maximise gum health. Unfortunately we see many patients every year who have been provided with low-cost treatments that have used low-cost implant components and laboratory work.
Peri-implantitis can take years to develop, progresses slowly, sometimes in fits and starts, and the fact that inappropriate materials or techniques have been used may only become evident later on. It can develop in patients who have a history of gum disease, those who have not had any gum disease. On the other hand, there are patients with very severe gum disease who have had no problems at all with their implants.
A high biting force from clenching or grinding teeth (‘bruxism’) also seems to cause bone loss around implants. People who are smokers or diabetic are more at risk of peri-implant problems.
Treating peri- implantitis

Treating peri-implantitis can be extremely challenging. At Dawood & Tanner we know that meticulous hygiene will improve comfort and slow down the progression of the condition. Treatment consists of cleaning under the gum of the implant meticulously using ultrasonics and jet-polishing and grafting with bone scaffold materials in order to replace the missing bone tissue or thicken the surrounding gum. This sort of treatment can make the area more comfortable and the peri-implant condition more quiescent, allowing for survival of the implant crown or bridgework.
Where the problem is persistent or there has been advanced bone loss, there is sometimes little alternative but to remove and replace an ailing implant, which may also mean loss of the implant restoration. In these circumstances, loss of the implant may be accompanied by a great deal of bone loss although we will generally find a solution which may involve the use of grafting, special custom implants such as Zygomatic implants, or specially made short implants.

For more information on dental implants or if you would like to book an appointment contact reception on 020 7935 0090.