tooth diagram comparing gingivitis and periodontitisWhile “gum disease” might not sound serious to some, it’s actually the number one reason for adult tooth loss. This is because its progression leads to bone loss and deterioration of the soft tissues. With less to support them, the teeth eventually become loose – and become candidates for extraction.

Biocompatible ceramic implants are one excellent option for replacing lost teeth. But are they a good option if you have a history of periodontal (gum) disease?

This was the focus of a review recently published in Evidence-Based Dentistry: Just how well do implants do when placed in tissues that have a history of disease?

To find out, its authors looked at data from 13 previous studies on periodontitis (advanced gum disease) and implant survival, along with secondary outcomes such as bone loss, pocket depth, and bleeding upon probing around the implant.

Each study also included details on supportive periodontal treatment (SPT) to help maintain the implants. It had to compare outcomes both for patients with a history of gum disease and those without, and include a record of peri-implantitis conditions (persistent infection around the implant).

Overall, they found that the implant survival rate dropped in patients with a history of periodontitis, even when SPT was provided. These patients also showed more bone loss, bleeding on probing, and pocket depth than patients with healthy gums.

While the authors noted that these findings were specific to implants with rough surfaces – survival rates were better for machined implants – these days, almost all implants are rough. The added texture helps them integrate better with the bone, creating a stable artificial root for the dentist to place a restoration on.

So does this mean that if you have a history of gum disease, implants aren’t even an option? Not necessarily. They can still work for you, provided that the disease is now under control.

dental implant partsFor one, the kind of SPT used in these studies likely excluded tools such as ozone therapy and nutrition that are common in holistic and biological dental offices like ours – tools that may improve the long-term prognosis of the tooth or teeth involved.

On a similar note, the implants under consideration were likely all titanium, which may contribute to conditions associated with peri-implantitis, which can, in turn, lead to implant failure. On the other hand, there’s evidence that the risk is lower with zirconia (ceramic) implants like those we use.

Above all, every patient is an individual and deserves to be treated as such. There’s no one-size-fits-all solution when it comes to replacing teeth. Always, we need to look at the big picture and discuss all of your treatment options, their pros and cons, so you can make the most informed decision possible – one that jibes with your needs, goals, and values.

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