It is important to control periodontal disease before placing dental implants.
Periodontal disease (or gum problems) has a high prevalence in the population (almost 90 percent to a greater or lesser extent of the disease). This raises many doubts as to what type of prosthesis can be used in these patients.
Dr. Rosa Gómez Laguna, director of the periodontics area at Crooke & Laguna, explains:
-What is periodontal disease?
-It is an infectious disease caused by plaque and affects the tissues surrounding the tooth, ie the gingiva, bone and periodontal ligament. Depending on the severity, there are cases in which it is limited to the gingiva and other cases in which the bone that supports the teeth is also lost, causing the mobility. Depending on the degree of involvement, we talk about gingivitis or periodontitis.
-Why is it produced?
-The origin is bacterial plaque that accumulates in the mouth after meals or by improper brushing.
But there are a number of predisposing or aggravating factors that facilitate development or progress such as smoking, diabetes, pregnancy, medications for hypertension, epilepsy or immunosuppressants.
In addition there is also a genetic predisposition to suffer the disease. Patients with alterations in the IL-1 gene have been shown to have an exaggerated inflammatory response and thus further bone destruction. If left untreated, the patient eventually loses dental pieces and the bone that supports them.
-So, can a patient with periodontal disease put implants?
“Of course, as long as the periodontal disease has been treated and controlled. In fact, there are several choices of treatment, if the patient suffers from periodontitis the support of his teeth is reduced, and it is not advisable to wear removable prostheses with hooks resting on those teeth or to carve the enamel of healthy teeth. In addition to the implants we avoid the collateral damages that sometimes lead to treatments with sleeves or bridges, such as pulpal disorders (which force “to remove the nerve” of the tooth) or caries under the prosthesis.
What is certain is that a patient with periodontitis has more risk of bacterial contamination to the implants, so it is very important to maintain periodic dental appointments and radiographic controls when possible.