Dental Hygienist's Role in Assessing Peri-Implantitis.

Abstract

The objective of this clinical case presentation is to discuss peri-implantitis due to its increasing prevalence in dental hygiene practice. Assessment: A 79 year old Caucasian female presented to the Dental Hygiene Clinic for periodontal maintenance and a dental exam. The medical history reveals a history of hypertension, atrial fibrillation, and the patient is taking Coumadin. The patient presented with generalized mild plaque-induced marginal and papillary gingivitis, however, the gingiva around the implant replacing #19 showed moderate gingival inflammation as evidenced by dark pink, bulbous, and spongy tissue with moderate bleeding on probing (BOP). The patient also presented with generalized chronic periodontitis as evidenced by 4-5mm clinical attachment level (CAL). Peri-implantitis was diagnosed on the implant with 6-9mm probing depths, 85% bone loss present on radiographs, and suppuration. DH Care Plan: Routine periodontal maintenance, oral hygiene instruction, and referral to the Graduate Periodontics Clinic for further evaluation of the implant. Follow up: The implant was diagnosed with a hopeless prognosis and scheduled for removal in the Graduate Periodontics Clinic. However, before the scheduled extraction, the patient reported that the implant had "fallen out" and it was not present at the 3 month periodontal maintenance appointment. Conclusion: Early recognition and intervention of peri-implant mucositis and peri-implantitis is crucial for the survival of the implant. Once peri-implantitis has reached an advanced stage, the prognosis of the implant is very poor and may require surgical treatment.