WCOI-AAID International Podium
Osseointegrated titanium implants are a prosthodontic treatment option, that is both functional and aesthetic for missing teeth. Approximately, 10% of private clinics provide implant treatment in Japan, and around 3 in 100 patients over the age of 40 have received implant treatment at one of these clinics according to a Survey of Dental Diseases in 2016.
An implant can provide long-term stability to an individual’s oral function, but neglecting the implants can result in unwanted consequences. Risk factors for peri-implantitis include: poor oral hygiene, smoking, alcohol consumption, a history of periodontal disease, uncontrolled diabetes, genetic traits, and the implant surface. All, except for the implant surface, are also risk factors for periodontitis. Currently, the prevalence of periodontal disease in adults exceeds 40 % in Japan. It is essential that dentists have both the knowledge and skill to treat and maintain periodontal disease, for implant treatment to be successful. Not only can it be difficult to place implants into patients with periodontitis, due to the loss of alveolar bone, but these patients also have a high risk of peri-implant diseases, leading to implant failure. The prevalence of peri-implant disease is reported to be 24 to 92% in functional implants that have been fitted for approximately 5 to 10 years The prevalence of peri-implantitis is 12 to 43%. The poor maintenance of implants increases the risk of peri-implantitis five-fold.
The tissue destruction by peri-implantitis leads to implant failure. Management of infections around the natural teeth is required for long-term periodontal health, and also maintenance of implants is required. It is a requirement to maintain implant health for a long period of time in order to keep the recovery of oral function. It will be essential for dentists to efficiently diagnose, and treat patients suffering from peri-implantitis as the need grows.
As peri-implantitis is a new disease, that dentists have little experience with, there are very few treatment options for this condition, a similar serious issue that occurred with periodontal disease. The goal of treatment is to arrest further periodontal tissue destruction, by eliminating soft and hard deposits that have accumulated on the root surfaces, also to create a new periodontal environment, so that the root surfaces are easier to clean. In order to achieve this goal, soft and hard periodontal tissue often has to be removed from the region. Once onset of peri-implantitis has occurred and destroyed tissue around the implant, it has been revealed that treatment and management of peri-implant inflammation is difficult. Therefore, it is also very important to prevent the development of peri-implant inflammation, by continuing to collect the findings from basic and clinical research, facilitating the discovery of effective treatment methods.
During a survey conducted in 2012, the prevalence of peri-implantitis was 17.6% and 12.0% at patient level and implant level respectively, at the TMDU Hospital. A treatment for peri-implantitis has not yet been established, therefore, I would like to introduce a treatment from the Department of Periodontology in TMDU.