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Peri-implantitis is an inflammatory disease that affects the tissues around a dental implant and progressively destroys the bone supporting it. It is one of the most important implant complications because, if it is not detected and treated in time, it can compromise the long-term survival of the implant.
The problem usually does not appear suddenly. In many patients, peri-implantitis starts with subtle bleeding, gum swelling or occasional discomfort when brushing. Because the implant itself does not have a nerve like a natural tooth, the disease may progress silently until bone loss is already advanced.
At Clínica Dental Asensio, all implant patients are enrolled in regular maintenance reviews precisely so the team led by Dr. Lucía Asensio Romero can detect the earliest signs of peri-implant disease before they become a major problem.
What is the difference between peri-implant mucositis and peri-implantitis?
Not all inflammation around an implant is peri-implantitis. The first stage is often peri-implant mucositis, which affects only the soft tissue and is usually reversible if treated early. Peri-implantitis is the more advanced stage, in which inflammation is already associated with bone loss around the implant.
| Condition | Main feature |
|---|---|
| Peri-implant mucositis | Inflamed gum around the implant, no bone loss |
| Peri-implantitis | Inflamed tissue plus progressive bone destruction |
This distinction matters because mucositis can often be reversed with professional cleaning and better hygiene, while peri-implantitis may require more intensive treatment, sometimes including surgical intervention.
Symptoms of peri-implantitis
The most common warning signs are:
If any of these signs appear, the patient should not wait for a routine hygiene appointment. Early assessment is essential because once significant bone loss develops, treatment becomes more complex.
Why does peri-implantitis happen?
Peri-implantitis is usually multifactorial. Bacterial plaque is a central trigger, but the real risk depends on many additional factors: history of periodontal disease, smoking, uncontrolled diabetes, poor prosthetic design, excess cement, bruxism and irregular maintenance visits.
In other words, the problem is not just “poor brushing”. Some implants fail because the prosthesis is difficult to clean, because bite forces are excessive, or because the patient was already at high periodontal risk before treatment.
How peri-implantitis is diagnosed
Diagnosis combines clinical examination and radiographic assessment. The dentist checks bleeding, probing depth, suppuration, soft tissue condition and compares current radiographs with previous records to identify bone loss around the implant.
This is one reason why implant follow-up should always be performed by a team experienced in implant dentistry, not just by general routine cleaning staff. The interpretation of implant bone levels and prosthetic risk factors is highly specific.
Treatment of peri-implantitis
Treatment depends on how advanced the disease is. Early cases may be controlled with professional decontamination of the implant surface, reinforcement of hygiene techniques and correction of local factors such as prosthetic overload or plaque-retentive areas. More advanced cases may require surgical access, implant surface detoxification, regenerative procedures or, in severe situations, removal of the implant.
The goal is always the same: stop disease progression, preserve as much supporting bone as possible and restore a cleansable, stable prosthetic environment.
Can peri-implantitis be prevented?
In many cases, yes. The best prevention combines proper planning from the start, high-quality prosthetic design, excellent daily hygiene and regular maintenance reviews. Patients with a history of periodontitis, smoking or bruxism need especially close monitoring.
If you already have implants and want to reduce long-term risk, read our guide on dental implant care.
Frequently asked questions about peri-implantitis
Does peri-implantitis always mean losing the implant?
No. If it is diagnosed early, treatment can often stop the progression and preserve the implant. The prognosis worsens when bone loss is advanced.
Is peri-implantitis painful?
Not always. Many cases progress with little or no pain, which is why maintenance visits are so important.
Can smoking cause peri-implantitis?
Smoking is a major risk factor because it affects tissue healing and increases the likelihood of inflammation and bone loss around implants.
How often should implants be checked to detect peri-implantitis?
Most patients should be reviewed every 6 to 12 months, with shorter intervals for high-risk cases.