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Early redness under implant crown could be a sign of implant disease

Implants have been around since 1965 and were originally used in science. Professor Branemark discovered that the Titanium cylinders being used in his experiments were stimulating bone growth around them.

Implants were then used in many medical and dental fields in attaching prostheses or teeth to bone.

The Titanium alloy used is very pure, bio-inert and noncorrosive. However in the mouth it is the bone that fails around implants in certain patients.

As all metals have a rough surfaces they can attract germs. In the healthy patient the implant is placed at the bone level and the healthy gum creates a protective cuff around the post of the implant. This can be seen in the picture above where the gum is pink, firm and stippled (like orange peel), except at one location.

When the cuff is loose, germs can get in and cause local inflammation, this is called mucositis as in the picture above.

Early peri-implantitis

The signs are very similar to gum disease in that early signs are redness and or puffiness without bleeding.

Brushing the gums around teeth and implants keeps them healthy and maintains the bone underneath.

Patients that smoke, are diabetics or immunocompromised may have a weakened defence mechanism that allows implant or gum disease to develop.

Routine check ups, visits to the hygienist and also home care/brushing with an electric tooth brush or bottle brushes can help reduce bacterial levels around implants.

Advanced peri-implantitis with associated bone loss

If germs are allowed to build up inside the gum cuff then the local body inflammation, in trying to neutralise the germs can also damage the bone, causing bone loss. This is called peri-implantitis.

Continuous presence of the germ biom can lead to the loss of the implant and the superstructure above.

The signs of implant disease can be redness, puffiness, bleeding, white fluid or pus, pain etc. The implant does not become mobile until much later on as the bone contact is very strong, even when there is little coverage.

The implant surfaces need to be uncovered, cleaned, smoothed and or antibiotic substances applied to disinfect them. The gums can then be allowed to heal naturally, but with bone loss, recession can occur and the implant surface may be visible.

Tepe bottle brushes

Tepe is a brand of sturdy bottle brushes. They can be brushed under bridgework or crowns and keep the gum cuff clean. They can be rinsed and dried and used twice daily for up to 2-3 weeks and then a new one is used.

Mouthwash can also be used once daily to kill off any unwanted germs as well.

Implants need monitoring and maintenance too and can slowly fail without you even realizing it. It is imperative, much like a car MOT that you get them checked regularly.