Gum Disease, Smokers, & Dental Implants
Can patients with a previous history of gum disease and/or smoking be treated with dental implants? This is a complicated question with a case by case risk assessment required. I will try to answer this question by reviewing a very thorough review article published in the Journal of Periodontology. Analysis of a large group of patients with dental implants showed the prevalence of peri-implantitis to be 18.8%. Peri-implantitis is characterized by inflammation and bone loss around dental implants. High risk patients included patients with a history of gum disease (bone loss) and smokers. The previous history of gum disease sub-group showed a slight increase in prevalence of peri-implantitis 21.1% and the smokers sub-group showed a significant increase 36.3%. Patients that are consistent with there home care and keeping up with cleanings are significantly less likely to have peri-implantitis. Therefore, patients should be aware of the risks associated with failing implants, and reluctant about treatment with dental implants if they have only seen a dentist sporadically. Dentist should be selective of who can be treated dental implants and not only concerned if they can pay the bill.
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The current case demonstrates a patient with a history of gum disease (bone loss) that has been stable for many years. He has been a patient for approximately 20 years and dedicated to supportive maintenance. A Straumann tissue level regular neck was surgically placed and restored after bone integration.