Biological implant complications and their management

Background: With the increasing popularity of dental implants the presence of implant complications is rising, and the question of how to best manage these complications still lingers in most clinicians' minds. This paper aims to provide clinicians with an overview of the most commonly encountered biologic implant complications as well as to provide guidelines as to how to treat them.

Available English literature was reviewed, including peer-reviewed journal publications and online resources. Several treatment modalities have been proposed to manage these complications, including non-surgical mechanical debridement, antiseptics, local and/or systemic antibiotics, lasers, resection with or without implantoplasty and regenerative approaches.

In this guideline, it is suggested that the treatment modalities should be chosen based on the severity of peri-implant diseases, amount of bone loss and the morphology of peri-implant bony defects. For peri-implant mucositis or peri-implant defects with less than 2 mm destruction, non-surgical treatments are recommended. For peri-implant defects with more than 2 mm destruction, surgical treatments (e.g., resection with or without implantoplasty, guided bone regeneration) are suggested that include removal of the implant if the bone loss is beyond repair.

The prevention of biological implant complications relies on careful planning, a thorough examination to assess etiological factors and a regular maintenance recall schedule. With early diagnosis, biological implant complications should be managed based on the severity of peri-implant disease, the amount of bone loss and the morphology of the peri-implant bony defects.