Peri-implantitis treatment in Brooklyn
How is peri-implantitis treated?
Peri-implantitis is infection around a dental implant that has already caused bone loss. It is treatable, and treatment starts without surgery: the implant surface is decontaminated, inflammation is brought under control, the bite and the crown are checked for factors feeding the problem, and the site is re-measured before anything else is considered. Surgery is used only when that non-surgical phase has not stopped the bone loss. At Brooklyn Periodontics in Downtown Brooklyn, Dr. Zidile and Dr. Choi treat peri-implantitis around implants placed anywhere, including implants placed by other offices.
Peri-implantitis is one of the conditions general dentists and other specialists send to us most often. Catching it early is what decides whether the implant is kept or lost.
Mucositis, peri-implantitis, and implant failure are three different things
These terms get used interchangeably online, and the difference decides the treatment. Getting the stage right is the first thing we do.
Peri-implant mucositis
Inflammation of the gum tissue around the implant with no bone loss. The gums bleed when probed or brushed and may look red or puffy. This stage is reversible with non-surgical care and better home hygiene, which is exactly why an early visit matters.
Peri-implantitis
The same inflammation, but bone around the implant has been lost. Probing depths are deeper, there may be bleeding or pus, and the bone level on a radiograph sits below where it started. The implant is often still solid. This stage is treatable, and the goal is to stop the bone loss and keep the implant.
Implant failure
The implant is mobile or has lost its integration with the bone. At that point no cleaning will save it. The implant is removed, the site is grafted, and a new implant is planned once the bone has healed.
How we diagnose it
Diagnosis is measured, not eyeballed. You see the same numbers and images we do.
Probing around the implant
Gentle probing depths at multiple points, plus whether the site bleeds or releases pus. Bleeding on probing is the earliest reliable warning sign.
Radiographic bone level
The current bone level compared against the level when the implant was restored, when that image is available. We can also evaluate you without your original records.
3D imaging when the defect shape matters
In-office cone beam imaging shows whether bone is lost on one wall or all the way around, which decides whether the defect can be regenerated later if it comes to that.
The crown, the bite, and the tissue
Excess cement, an overloaded bite, a loose abutment screw, an over-contoured crown, or too little firm gum tissue can all drive peri-implantitis. Treating the infection without correcting the cause is why it comes back.
Treatment is a ladder, and it starts non-surgically
We work up the ladder only as far as your case requires, and we re-measure before each step up.
01
Decontamination and debridement
The implant surface and the pocket around it are cleaned with instruments and irrigation chosen not to damage the implant surface. This is done under local anesthesia and does not involve opening the tissue.
02
Local antimicrobials where indicated
Antimicrobial rinses or locally delivered agents are used when the infection warrants it, as an adjunct to the mechanical cleaning, not a replacement for it.
03
Correct what caused it
Excess cement removed, the bite adjusted, a loose screw retightened, a crown contour that cannot be cleaned sent back to your dentist for revision. Smoking and uncontrolled diabetes are addressed as part of the plan because both change the outcome.
04
Home care rebuilt around the implant
Implants are cleaned differently than teeth. We show you the specific tools and technique for your restoration, then set a maintenance interval, often shorter than the standard six months.
05
Re-evaluation
You come back so we can measure the same sites again. If the pocket has shrunk, bleeding has stopped, and the bone level is holding, we stay non-surgical and move you to maintenance.
06
Surgical access, only if the numbers do not improve
If bone loss continues, we open the tissue to reach and thoroughly clean the implant surface. Depending on the defect shape, that visit may include regenerative grafting to rebuild bone, or implantoplasty to smooth an exposed implant surface so it stops collecting bacteria.
After treatment, peri-implantitis is managed, not cured once
An implant that has had peri-implantitis stays at higher risk. We keep you on a defined maintenance interval with the same measurements taken each visit, so a change is caught at the millimeter stage rather than the emergency stage. Your general dentist keeps doing your restorative care and regular cleanings, and we coordinate with them on the interval.
We treat implants we did not place
A large share of the peri-implantitis cases we see involve implants placed elsewhere, sometimes by dentists who then refer the case to us themselves. That is normal specialist practice and nothing to be awkward about. You do not need your original surgical records, and you keep your relationship with the dentist who restored you.
Questions patients ask
Peri-implantitis, answered
- Can peri-implantitis be treated without surgery?
- Often, yes, especially when it is caught early. Non-surgical treatment means decontaminating the implant surface, controlling the infection, correcting the bite or restoration factors that caused it, rebuilding home care, and then re-measuring. Surgery is reserved for cases where bone loss keeps progressing after that phase.
- Can peri-implantitis be cured?
- It can be arrested and the implant can often be kept, but the site stays at higher risk afterward, so it is managed with ongoing maintenance rather than considered permanently cured. Peri-implant mucositis, the earlier stage with no bone loss, is fully reversible.
- What is the difference between peri-implant mucositis and peri-implantitis?
- Mucositis is inflammation of the gum tissue around an implant with no bone loss and is reversible. Peri-implantitis is that same inflammation once bone around the implant has been lost. Both are diagnosed with probing and radiographs.
- Will I lose the implant?
- Not necessarily. Many implants with peri-implantitis are kept when the infection is stopped and the cause is corrected. An implant is removed when it has lost integration and is mobile, or when the remaining bone cannot support it. We tell you which situation you are in after the exam, not before.
- What are the signs of peri-implantitis?
- Bleeding when you brush or floss around the implant, red or swollen gum tissue, pus or a bad taste, gum recession exposing the metal, deepening pockets, tenderness or pressure, and on radiographs, bone loss around the implant. A loose crown is not the same as a loose implant and is often an easy fix.
- Do you treat implants placed at another office?
- Yes. We routinely treat peri-implantitis around implants placed elsewhere, including cases referred to us by the dentist or specialist who placed them. We do not need the original surgical records to evaluate you.
- Is peri-implantitis treatment painful?
- The non-surgical phase is done under local anesthesia and most patients compare it to a deep cleaning. If a surgical phase is needed, you receive full written pre-operative and post-operative instructions and both doctors' direct cell numbers.
- How much does peri-implantitis treatment cost?
- It depends on how many implants are involved and whether the case stays non-surgical. You get the fee and the insurance breakdown in writing before anything is scheduled.
Related
Failing or loose dental implant
What to do today if your implant hurts, moves, or is draining.
Second opinion
Bring us a diagnosis or treatment plan you are unsure about.
Dental implants in Brooklyn
Candidacy, grafting, full-arch options, and the healing sequence.
Non-surgical gum treatment
How we treat periodontal disease before considering surgery.
Have the implant looked at before more bone is lost.
Bone lost around an implant does not come back on its own. An exam takes about an hour and tells you exactly which stage you are at.