Periodontitis and dental implants — that sounds like a contradiction. In fact, periodontitis is one of the most common causes of tooth loss, and many patients wonder: Can I still get an implant? The honest answer: yes — but not immediately, and not without pre-treatment.
Important note
An implant placed in an untreated periodontitis environment has a significantly higher failure rate. Pre-treatment is not optional — it is a prerequisite.
What is periodontitis — and why does it matter for implants?
Periodontitis is a bacterial inflammation of the tooth-supporting structures — the bone, periodontal ligament, and gums. Left untreated, it leads to bone loss, tooth mobility, and ultimately tooth loss. For implants, this is critical for two reasons:
- 1.Bone volume: Periodontitis destroys exactly the bone into which the implant must be placed. Too little bone = no stable implant.
- 2.Bacterial load: The periodontal bacteria in the mouth significantly increase the risk of peri-implantitis — the implant equivalent of periodontitis.
How high is the risk really?
| Patient group | Peri-implantitis risk | Implant loss (10 yrs) |
|---|---|---|
| Periodontally healthy | ~10–15% | ~3–5% |
| Treated periodontitis + aftercare | ~20–25% | ~8–10% |
| Untreated periodontitis | >40% | >20% |
The correct sequence: treat periodontitis first, then implant
Periodontal diagnostics
Pocket depth measurement, X-ray (CBCT), severity classification (Grade I–IV).
Active periodontal therapy (APT)
Professional cleaning, scaling and root planing — removal of all deposits below the gum line. Duration: 4–8 weeks.
Re-evaluation
After 8–12 weeks: check whether inflammation has resolved. Pocket depths ≤4 mm are the target.
Surgical periodontal therapy if needed
For deep pockets (>6 mm) or furcation involvement, a surgical procedure may be necessary.
Implant planning
Only once periodontitis is stable is the implant planned — with CBCT, 3D planning and bone augmentation if needed.
Lifelong aftercare (SPT)
Supportive periodontal therapy every 3–6 months — not optional, but a prerequisite for implant success.
When is an implant possible — and when not?
- • Periodontitis successfully treated (stable conditions)
- • Pocket depths ≤4 mm, no bleeding on probing
- • Sufficient bone volume available (or augmented)
- • Patient committed to regular aftercare (SPT)
- • No active inflammation in treatment area
- • Active periodontitis (untreated or uncontrolled)
- • Poor oral hygiene despite counselling
- • Heavy smoking (>10 cigarettes/day) without willingness to reduce
- • Uncontrolled diabetes (HbA1c >8%)
- • Non-compliance with aftercare
Your checklist: Am I ready for an implant?
Conclusion: Periodontitis is not a disqualifier — but a condition
Periodontitis does not mean you cannot get an implant. It means you must first create the foundation — a healthy, inflammation-free jaw. Patients who take this preparation seriously and attend aftercare consistently can achieve long-term implant success even with a history of periodontitis.
Institut für Implantologie und digitale Zahnmedizin Wien
Fachärztliches Team IIDZ Wien
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