Gum Disease, Smokers, & Dental Implants

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.

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