With the development of implantation technology, more and more patients prefer this method of restoring lost teeth, as the most reliable, aesthetic and convenient. Set it and forget it! This is exactly what happens in most cases, unless the plans of the doctor and his patient are disrupted by the most formidable complication, due to which the implant can be lost - peri-implantitis. This is what visitors to numerous dental forums scare each other with, so much so that some give up the idea of installing an implant altogether. In this article, let's figure out what peri-implantitis is, how to avoid it, and, if necessary, treat it.
What is peri-implantitis?
Peri-implantitis is an inflammation of the tissues and bone surrounding the implant, which ultimately, without timely intensive treatment, leads to bone loss and loss of the implant.
Peri-implantitis is much easier to prevent than to stop a process that has already begun. The main cause of the disease is a bacterial infection, which can occur either at the moment of implantation, and then the symptoms of the disease appear a few days after the operation, or after some time - from several months to several years.
What complications can occur after taking antibiotics?
Everyone knows that after taking antibiotics, dysbiosis can begin, accompanied by bloating and diarrhea. A person has been ill and was treated with antibiotics, which means he drinks bifidobacteria to protect his body. And there are quite a lot of drugs containing bacteria beneficial to the intestines on today’s pharmaceutical market. There are even drugs that are taken not after, but during antibiotic treatment - and they protect the intestinal flora.
Thrush can also be caused by long-term use of antibiotics. And here antibacterial therapy is used, despite the fact that it ultimately reduces immunity and creates additional stress on the kidneys and liver.
However, in addition to all of the above, antibacterial therapy also thins bone tissue! Antibiotics are necessary in the modern world, but you need to know that in addition to dysbiosis and thrush, which we have learned to treat immediately, the use of antibiotics causes the formation of cavities in the bones and provokes arthritis. Not everyone knows about this.
This is especially dangerous in childhood. And taking antibiotics during pregnancy is generally contraindicated, since it primarily affects the fetus and can lead to severe diseases of the musculoskeletal system in the child.
Research by American scientists from the University of Pennsylvania has shown that taking antibiotics in childhood significantly (!) increases the risk of developing juvenile rheumatoid arthritis (in children under 16 years of age). And it is characterized by a pronounced inflammatory process and a significant limitation of the motor ability of the affected joint. This may further affect the length of the limbs and as a result, the child’s arms or legs may grow to different lengths.
American scientists conducted an analysis of 153 cases of the disease in children under 16 years of age. The result was amazing! It turned out that in children who underwent 3-5 courses of antibiotic treatment, the risk of juvenile arthritis was 3.8 times, and with 1-2 courses - 3.1 times. This means that the higher the dose and frequency of antibiotics taken, the greater the likelihood of developing rheumatoid arthritis. We also cannot discount the effect of antibiotics on the intestinal flora.
Dysbacteriosis after taking antibiotics can contribute to the development of autoimmune diseases, among which rheumatoid arthritis is far from the least important.
Why does peri-implantitis occur?
According to statistics, during implantation, more than 95% of implants are successfully installed and take root. 5% of failures are associated with various reasons, but in approximately 1% of cases, peri-implantitis is “to blame” for the loss of the implant, i.e. inflammation affects approximately 1 artificial tooth root out of 100. You need to understand that complications are possible with any surgical intervention. It depends on the patient's health and immune system. If the patient has disorders or may have a decrease in immunity under the influence of unfavorable external factors, this must be taken into account. That is why implantation requires preliminary thorough diagnosis by the surgeon.
Other causes of implant infection and the development of peri-implantitis can be:
- Incorrect behavior of the patient himself after implantation:
- poor hygiene,
- violation of the treating dentist’s recommendations for the care of implants,
- increased chewing load, careless attitude towards your artificial teeth, gum injuries near the implant,
- smoking,
- ignoring routine examinations to monitor the condition of the implant roots.
- Mistakes made by specialists during implantation:
- an inappropriate prosthetic technique was chosen,
- the implant is placed in the wrong place,
- the implant is installed in a hole with a larger diameter than required,
- the load on the implant was incorrectly calculated,
- a complete diagnosis was not carried out and/or the patient’s health status was incorrectly assessed before implantation,
- During the operation, asepsis was violated.
- A low-quality implant was installed. This can happen due to the fault of the dentist or at the insistence of the patient himself.
- There was a source of infection in the patient's mouth - caries, periodontal disease, dental plaque and calculus. In order for implantation to proceed without complications, all sources of possible infection in the oral cavity must be eliminated at the preparation stage.
Features of pathology classification
Experts distinguish several types of the disease in accordance with the existing symptoms. According to local manifestations, erysipelas is divided:
- to erythematous;
- bullous-hemorrhagic;
- erythematous-bullous;
- erythematous-hemorrhagic.
Based on the complexity of the process and intoxication indicators, mild, moderate and severe forms are distinguished. The prevalence of the lesion is of great importance, which allows us to determine:
- localized type - with limitation of the infectious focus in one area;
- widespread - with spread to the adjacent anatomical part;
- migrating - with lesions occurring within several places.
Primary erysipelas is registered in the patient for the first time, repeated inflammation is recorded after 2 years or forms on another area of the skin. A recurrent form of pathology occurs after the initial appearance within 2 days or two years in the same place.
Symptoms of peri-implantitis:
- The disease begins with redness, discomfort and swelling of the gums in the area of the installed implant.
- There is bleeding of the gums in the problem area.
- At the site of inflammation, connective tissue begins to grow.
- The gum moves away from the implant, as in periodontal diseases, and a periodontal pocket forms around the titanium rod.
- Serous fluid and pus may be released from the pocket, and a fistula may form.
- The X-ray image reveals a noticeable loss of bone tissue around the implant.
- The implant becomes loose, the patient feels its mobility, this provokes further destruction of the bone around the titanium rod.
- Ultimately, if the inflammatory process is not stopped, implant rejection occurs.
Clinical symptoms
The duration of the incubation period for erysipelas ranges from 2-3 hours to 5 days. In case of relapses, exacerbation occurs against the background of stressful situations and general hypothermia. Most patients experience an acute onset of the disease.
At the initial stage of erysipelas, general signs of intoxication develop within 23-48 hours in 50% of patients. Clinical manifestations of the disease are presented:
- headache attacks;
- weakness, chills;
- muscle discomfort;
- nausea and vomiting – in 30% of patients;
- an increase in temperature from 38 to 40 degrees;
- the occurrence of unpleasant sensations, burning in the area of the future site of inflammation.
After the first signs of the development of the pathological process and until the middle phase of erysipelas, no more than 2 days pass. The febrile state and symptoms of intoxication of the body reach their peak, and local manifestations of the disease begin to form.
In most cases, erysipelas affects the lower extremities, less often it appears in the face and hands. Sometimes it can occur in the area of the torso, intimate area, and mammary glands.
How is peri-implantitis treated?
The success of treatment for peri-implantitis depends on what stage of the disease it is started at: the earlier, the better the prognosis.
Treatment is aimed primarily at relieving inflammation in the area and restoring bone volume once it has begun to be lost. Therefore, there are 2 main stages in treatment - sanitation of the inflamed area and surgical bone augmentation.
- Before starting treatment, the doctor conducts a diagnosis. The main stage of such a diagnosis will be a 3D CT scan to accurately determine the affected area and the condition of the bone tissue.
- Then professional hygiene of the implant and adjacent areas is carried out - removal of soft dental deposits and tartar from the dental crown and from the subgingival space using ultrasound.
- Next, surgical sanitation of the area of inflammation is carried out - the abscesses are opened. Cleaning of periodontal pockets is carried out in the same way as for periodontal diseases - using special curettes or the Vector device. It is advisable that the problematic implant is not loaded.
- At the same time, bone grafting can be performed using the method of directed bone regeneration using bone chips and regenerating membranes.
- In parallel, the patient is given local and general antibacterial therapy and antibiotics are prescribed.
- When treating peri-implantitis, it is very important to maintain daily hygiene using antiseptic drugs.
The result of treatment is necessarily monitored by repeated x-ray diagnostics.
It must be remembered that peri-implantitis is prone to frequent relapses, therefore, after treatment, monitoring the condition of the implants and increased attention to proper hygiene are MANDATORY.
Causes of the disease
Erysipelas is provoked by group A streptococcus; the source of infection is carriers of the infection or sick people. The disease is contagious and appears when a pathogen is transmitted. Experts identify individual factors that predispose to the formation of pathology, presented by:
- congenital immune defects;
- old age;
- chronic infectious diseases;
- problems with venous and lymphatic drainage;
- long-term therapy with steroids and drugs that suppress the immune system.
In childhood, infection with erysipelas is possible. Parents should remember that close contact with an infected person becomes a source of disease development in children.
The formation of recurrent erysipelas is associated with the presence of concomitant pathological processes:
- with lymphostasis;
- diabetes mellitus;
- chronic insufficiency of venous vessels;
- foci of streptococcus in the body.
Provoking factors for erysipelas include regular hypothermia or a stationary standing position for many hours (occupational prerequisites for the disease).
Prevention of peri-implantitis
From all of the above, it follows that peri-implantitis is much easier to prevent than to treat later. In order to protect yourself as much as possible from such a complication, both immediately after implantation and during subsequent life with an implant, you must:
- Carefully monitor oral hygiene, use not only a toothbrush and toothpaste to care for teeth and implants, but also special products - a monotuft brush, a dental brush, special dental floss and an irrigator. Visit a hygienist regularly for professional oral hygiene.
- Do not violate the recommendations of your doctor immediately after the implantation procedure.
- Pay attention to your health, strengthen your immune system, and don’t smoke.
- Regularly undergo scheduled examinations with your attending physician with RG diagnostics at least once a year to monitor whether there is bone atrophy.
- Carefully choose the clinic and doctor where you get implants.
- Place implants of brands that have already proven themselves among doctors and patients - in this case, the savings turn against the patient, because If the implant fails, you will have to undergo quite expensive treatment and pay for the implantation again.
How to protect joints and immunity after taking antibiotics?
By taking bifidobacteria and thereby protecting the intestinal microflora, of course, the risk of developing rheumatoid arthritis is somewhat reduced. However, this is not enough for healthy bones and joints. To protect your joints and bones after taking antibiotics, they need vitamins!
First of all, vitamin D, which is involved in calcium phosphate metabolism, protects joints and bones from the harmful effects of antibiotics. It helps absorb phosphorus and calcium from the intestines and distributes it to bones and joints. Vitamin D has immunosuppressive and anti-inflammatory effects! This increases the opportunity to avoid the development of autoimmune diseases, including rheumatoid arthritis. Another important vitamin for joints, ligaments and bones is vitamin B6, which is also involved in phosphorus-calcium metabolism. Vitamin B6 has an effect on the functioning of the nervous system and on the process of hematopoiesis, the disruption of which is one of the complications after taking antibiotics.
These two important vitamins, which help protect joints after taking antibiotics, are part of the Osteo-Vit vitamin complex, and they enhance the effect of drone brood. Drone brood is not only a storehouse of all substances valuable for the health of joints and bones and a healing agent. It affects hormonal levels, disruption of which in adolescence or menopause also causes a number of diseases of the bone skeleton and joints.
Take antibiotics only as prescribed and under the supervision of a doctor! And if you can’t do without antibacterial therapy, learn how to properly protect your joints!
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