Dental implant infection (peri-implantitis): causes and modern treatment with GalvoSurge®

Dental implants have revolutionised modern dentistry, offering effective solutions for replacing lost teeth and improving oral function and aesthetics.

The benefits offered by implants are numerous and extremely important for dental health: they stimulate the bone, prevent bone resorption, maintain the integrity of the jawbone and support facial contours. For this reason, the success of the implant is a priority for every patient, as well as for the medical team.

However, there are situations where problems arise following dental implant treatment. Infection of a dental implant (peri-implantitis) is one such possible complication, and in this article we will discuss the causes, symptoms and, above all, the benefits of GalvoSurge technology in saving a dental implant.

Peri-implantitis is an infection that develops around a dental implant and is mainly caused by the build-up of bacterial plaque. This causes inflammation of the gums and, over time, leads to the loss of the bone supporting the implant.

More specifically, as the surrounding bone is resorbed, the implant loses its stability. If not treated in time, peri-implantitis can progress and gradually lead to the loss of the dental implant.

This condition may present with some or all of the following specific symptoms: 

• redness and tenderness of the gums around the implant
• bleeding when brushing or on palpation
• increased pocket depth
• mobility
• pus
• pain

“The surface of a dental implant, which is often slightly rough, promotes the adhesion of biofilm, known as bacterial plaque. For this reason, oral hygiene following dental implant treatment is essential. Furthermore, as some of the symptoms of peri-implantitis can resemble those of gingivitis, it is important to monitor any signs closely to prevent the condition from worsening,” explains Dr. Maria Receanu, a dentist at the DENT ESTET clinics.

Peri-implantitis occurs mainly as a result of an inflammatory reaction in the tissues surrounding the implant to the bacterial plaque that forms on its surface. 

However, there are a number of risk factors, so it is important to be aware of them in order to identify and prevent peri-implantitis: 

Behavioural risk factors

• Smoking: Considered a major risk factor, similar to its role in the development of periodontitis.
• Poor oral hygiene: The build-up of bacterial plaque due to inadequate oral hygiene increases the risk of peri-implantitis.

Systemic risk factors

• Diabetes: This can negatively affect healing and increase susceptibility to infection.
• Osteoporosis: Loss of bone density can compromise implant stability.
• Immunosuppression: A weakened immune system can reduce the body’s ability to fight off infections.

Local and technical factors

• Bone quality and quantity: Type 1 bone, rich in cortical bone, may adversely affect angiogenesis and the rate of tissue regeneration at the interface.
• Occlusal overload: Excessive forces on the implant can lead to microfractures and peri-implant bone loss.
• Implant characteristics: Implants with rough surfaces may promote the accumulation of bacterial biofilm, increasing the risk of infection.

Other factors

• History of periodontitis: Patients with a history of periodontal disease are at increased risk of peri-implantitis.
• Soft tissue quality: A thin periodontal phenotype may affect the long-term stability of peri-implant tissues.

Peri-implantitis does not occur suddenly and often progresses without severe pain in its early stages. It is therefore important to be alert to certain abnormal reactions following dental implant surgery, which may indicate the onset of an infection.

Inflammation and gum recession

An early sign is inflammation of the gum tissue surrounding the implant. The gum may become red, swollen and tender, and over time, gum recession may occur, causing a larger portion of the implant to become visible. This may indicate bone loss around the implant.

Bleeding of the gums around the implant

Bleeding when brushing or chewing, localised pain or a feeling of pressure around the implant may signal a possible infection of the dental implant.

Unpleasant odour or persistent taste

Such a symptom may indicate the presence of bacteria beneath the gums, even if oral hygiene appears to be adequate.

Implant mobility

This is the most worrying symptom. A properly osseointegrated implant should not move. Even slight mobility is a warning sign and requires immediate assessment by the implantologist to prevent the worsening of peri-implantitis and loss of the implant.

“There is a tendency to believe that, once an implant has integrated well, the problem is permanently resolved. The truth is that implants need to be looked after just like natural teeth. This means that rigorous oral hygiene is required, as well as regular visits to the dentist. Peri-implantitis can progress subtly, without obvious pain, which is why regular check-ups are essential. “When detected early, this condition can be treated effectively, including with the help of GalvoSurge® technology,” explains Dr. Alexandru Georgescu, Medical Director at DENT ESTET.

When an infection affects the bone surrounding the implant, prompt treatment is essential to eliminate the cause – the bacterial biofilm – without damaging the implant surface. GalvoSurge® technology, available at DENT ESTET clinics, offers a modern and effective solution for saving dental implants.

GalvoSurge® is a system developed by Straumann® that uses an innovative electrochemical mechanism to thoroughly clean and decontaminate the implant surface. The procedure takes approximately 2 minutes and works gently, removing bacterial biofilm even from the titanium’s microstructures, without scratching or damaging the implant.

Unlike traditional mechanical or laser methods, which can damage the implant surface, GalvoSurge® enables thorough and controlled cleaning.

This treatment is recommended for cases of moderate or advanced peri-implantitis, particularly where there is bone loss around the implant or where conventional methods have not produced the desired results.

The expected outcomes include a significant reduction in inflammation, a lower risk of recurrence and an increased chance of long-term implant retention. When the procedure is carried out in a timely manner and complemented by proper oral hygiene and regular check-ups, treatment with GalvoSurge® can make the difference between losing and saving a dental implant. 

Prevention is essential for reducing the risks associated with dental implants and for avoiding complications such as peri-implantitis. Although the success rate of implants is very high, maintaining long-term health depends both on the patient and on how the treatment is planned and carried out.

Peri-implantitis can be prevented by:

• educating the patient on the importance of regular visits to the dentist
• rigorous oral hygiene: brushing twice a day and using auxiliary aids (oral irrigator, interdental brushes, dental floss)
• improving blood sugar control in people with diabetes
• giving up smoking (including e-cigarettes)
• reducing bruxism and/or parafunctional habits
• periodontal therapy to eliminate gum inflammation and achieve periodontal stability
• correct selection of the implant type and digital planning of the procedure. The use of premium systems and modern digital guidance technologies contributes to precise positioning and optimal integration into the bone.

A proper understanding of the risks that may arise following dental implant surgery and adherence to medical recommendations contribute significantly to maintaining a functional and stable implant in the long term.
 

1. M. Augthun 1, J. Tinschert, A. Huber – In vitro studies on the effect of cleaning methods on different implant surfaces, Journal of Periodontology, 1998
2. E.S. Karring, A. Stavropoulos, B. Ellegaard, T. Karring – Treatment of peri-implantitis using the Vector system, Clinical Oral Implants Research, 2005