What is peri-implantitis and how is it treated?

Last reviewed: April 2026 · Based on current clinical protocols at DenCos, Hoofddorp

Peri-implantitis is a bacterial infection that destroys the bone surrounding a dental implant. It is the leading cause of implant loss after successful osseointegration, affecting 10–20% of implant patients according to a consensus report by the European Federation of Periodontology. The condition is closely related to periodontitis — the same type of infection that destroys bone around natural teeth — but peri-implantitis often progresses faster because implants lack the protective periodontal ligament that natural teeth have. At DenCos in Hoofddorp, peri-implantitis is prevented, detected, and treated by Dr. Gang Wu (BIG 29918905102), whose dual qualification as periodontist and implantologist makes him uniquely suited for this condition.

This article explains what peri-implantitis is, how it develops, how to recognise it, and what treatment options are available at DenCos.

What is the difference between peri-implant mucositis and peri-implantitis?

Peri-implant disease occurs in two stages, similar to the gingivitis-to-periodontitis progression around natural teeth:

Peri-implant mucositis (early stage)

• Inflammation of the gum tissue around the implant without bone loss
• Caused by bacterial plaque accumulation on the implant surface
• Fully reversible with professional cleaning and improved home care
• Affects 20–30% of implant patients at some point
• Signs: red, swollen, or bleeding gums around the implant

Peri-implantitis (advanced stage)

• Inflammation of the gum with progressive bone loss around the implant
• Develops when mucositis is left untreated
• Not fully reversible — lost bone does not grow back without surgical intervention
• Affects 10–20% of implant patients
• Signs: deepening pockets, pus, bone loss visible on X-ray, implant mobility in severe cases

At DenCos, Dr. Wu checks for both conditions at every maintenance visit using standardised peri-implant probing and periodic X-rays. Early detection of mucositis — before it progresses to peri-implantitis — is the most effective prevention strategy.

What causes peri-implantitis?

The primary cause is bacterial plaque that accumulates on the implant surface and triggers an inflammatory response. However, several risk factors significantly increase the likelihood of developing peri-implantitis:

• History of periodontitis — patients who lost teeth due to periodontitis are at the highest risk. The same bacteria that caused the original gum disease can colonise the new implant.
• Smoking — reduces immune function and blood flow, impairing the body's ability to fight infection around the implant.
• Poor oral hygiene — inadequate brushing and interdental cleaning allows plaque to accumulate.
• Infrequent maintenance visits — without professional cleaning every 3–6 months, early inflammation goes undetected.
• Diabetes — uncontrolled blood sugar creates a favourable environment for bacterial growth and impairs healing.
• Excess cement — residual cement from the crown can harbour bacteria below the gum line.

At DenCos, Dr. Gang Wu addresses these risk factors proactively. Patients with a history of periodontitis receive periodontal treatment before implant placement, and all implant patients enter a structured maintenance programme tailored to their individual risk profile.

How do you recognise peri-implantitis?

Peri-implantitis is often painless in its early stages — which is why professional monitoring is so important. Watch for these warning signs:

• Bleeding when brushing or probing around the implant
• Red, swollen gums around the implant crown
• Deepening pockets — measurable only with a periodontal probe
• Pus between the implant and the gum
• Bad breath or bad taste that persists despite good oral hygiene
• Bone loss visible on X-ray (usually detected during routine check-ups)
• Implant feels loose — a late sign indicating advanced bone loss

If you notice any of these symptoms around your implant, contact your periodontist rather than waiting for your next scheduled appointment. At DenCos in Hoofddorp, Dr. Wu can assess the implant within a single visit using probing measurements and digital X-rays.

How is peri-implantitis treated?

Treatment depends on the stage and severity. At DenCos, Dr. Gang Wu follows an evidence-based, staged approach.

Non-surgical treatment (mucositis and early peri-implantitis)

• Mechanical debridement — removal of plaque and biofilm from the implant surface using specialised instruments that do not scratch titanium
• Antiseptic therapy — chlorhexidine rinses or local antiseptic application
• Antibiotic therapy — local or systemic antibiotics in selected cases
• Home care optimisation — personalised instruction on cleaning around implants with interdental brushes, water flossers, and appropriate brushes

Surgical treatment (moderate to severe peri-implantitis)

When bone loss has occurred, surgery is typically required:

• Open flap debridement — the gum is lifted to access the implant surface, which is thoroughly cleaned and decontaminated
• Implant surface decontamination — using methods such as air-powder abrasive devices, citric acid, or laser decontamination
• Bone regeneration — bone graft material and biocompatible membranes are placed to rebuild lost bone around the implant
• Resective surgery — in some cases, reshaping the bone and repositioning the gum to eliminate deep pockets

At DenCos, Dr. Wu's periodontist training gives him an advantage in peri-implantitis surgery — the techniques are essentially the same as those used in advanced periodontal surgery, applied to the implant environment.

How do you prevent peri-implantitis?

Prevention is far more effective than treatment. The following measures significantly reduce your risk:

At home

• Brush twice daily with a soft electric toothbrush, paying special attention to the gum line around the implant
• Clean around the implant daily with interdental brushes or a water flosser — these are more effective than floss around implant crowns
• Do not smoke — smoking is the strongest modifiable risk factor
• Use a non-abrasive toothpaste to protect the implant crown surface

Professional maintenance

• Visit your periodontist every 3–6 months — frequency depends on your risk profile
• Peri-implant probing at each visit to detect early pocket deepening
• Periodic X-rays (annually or as needed) to monitor bone levels
• Professional biofilm removal using implant-safe instruments

At DenCos, every implant patient is enrolled in a long-term maintenance programme from day one. Dr. Wu and the hygiene team monitor each implant systematically, adjusting the maintenance interval based on your individual response. Patients with a history of periodontitis or gum recession receive more frequent monitoring.

This proactive approach is why DenCos maintains consistently high implant success rates for patients from Hoofddorp, Haarlemmermeer, Haarlem, Amsterdam, and surrounding areas.

Why is a periodontist the right specialist for peri-implantitis?

Peri-implantitis is, at its core, a periodontal disease — it involves the same inflammatory and bacterial processes as periodontitis. The surgical techniques used to treat it — open flap debridement, bone grafting, guided tissue regeneration — are periodontal procedures applied to implants.

Dr. Gang Wu at DenCos holds dual registration as both periodontist and implantologist. This means he:

• Understands the disease biology — he treats periodontitis and peri-implantitis with the same fundamental knowledge
• Performs the same surgical techniques on both natural teeth and implants
• Manages the full implant lifecycle — from initial placement to long-term maintenance and, if needed, salvage treatment
• Prevents peri-implantitis before it starts — by treating existing periodontal disease before placing implants

This integrated expertise is rare and provides a meaningful clinical advantage for implant patients at DenCos.

Next step

Have an implant and noticed bleeding, swelling, or a bad taste around it? Do not wait — early treatment prevents bone loss and implant failure.

Book a peri-implant check-up at DenCos in Hoofddorp, or call us at 023-792 0463. Dr. Gang Wu will assess your implant, check for bone loss, and provide immediate treatment if needed. Appointments available Tuesday through Thursday until 18:30.