Board-certified periodontist Dr. Chanook David Ahn diagnoses and treats peri-implantitis with a save-first approach. Non-surgical debridement, laser decontamination, and surgical bone regeneration to rescue failing implants. Located in the South Coast Metro area, serving Costa Mesa, Irvine, Newport Beach, Santa Ana, and Tustin.
Peri-implantitis is an inflammatory condition that affects the tissues surrounding a dental implant, causing progressive bone loss that can ultimately lead to implant failure. It is the implant equivalent of periodontitis, the advanced gum disease that destroys the bone supporting natural teeth. When bacteria colonize the surface of a dental implant and penetrate below the gum line, the resulting infection triggers an inflammatory response that gradually erodes the jawbone anchoring the implant in place. Without treatment, peri-implantitis advances until the implant loosens and must be removed.
Research published in the Journal of Dental Research estimates that peri-implantitis affects approximately 20 to 22 percent of all dental implant patients and up to 10 percent of all implants. These numbers mean that millions of patients worldwide are living with implants that are actively losing bone support. The condition can develop months or years after implant placement, and many patients are unaware they have it because early-stage peri-implantitis is often painless. This is why regular monitoring by a periodontist who understands implant biology is essential for every implant patient.
At The Loft Dental Studio in Costa Mesa, board-certified periodontist Dr. Chanook David Ahn specializes in diagnosing and treating peri-implantitis using a comprehensive, save-first approach. Dr. Ahn has placed over 5,000 dental implants during his career, and this extensive experience with implant placement gives him a deep understanding of why implants fail and how to rescue them before it is too late.
It is important to understand the distinction between peri-mucositis and peri-implantitis because the two conditions require different treatment approaches and carry very different prognoses. Peri-mucositis is the earlier, reversible stage of implant disease. It involves inflammation of the soft tissue (gum) surrounding the implant but without any bone loss. Bleeding when probing around the implant, redness, and swelling are the hallmark signs. Peri-mucositis is fully reversible with professional cleaning and improved oral hygiene, much like gingivitis around natural teeth.
Peri-implantitis develops when peri-mucositis is left untreated and the infection spreads from the soft tissue into the bone. Once bone loss begins, the condition is no longer reversible through cleaning alone. The bone destruction creates deeper pockets around the implant that harbor more bacteria, which drives further bone loss in a self-reinforcing cycle. This is why early detection matters: catching the problem at the peri-mucositis stage means simple, non-surgical treatment can resolve it completely, while peri-implantitis may require surgical intervention to halt bone loss and rebuild supporting structure.
Recognizing the warning signs of peri-implantitis early gives you the best chance of saving your implant. Many patients assume that because implants are not natural teeth, they cannot develop disease. This is incorrect. While implants cannot develop cavities, they are fully susceptible to the same bacterial infections that destroy bone around natural teeth. Here are the signs that your implant may be in trouble.
Important: Some patients with peri-implantitis experience no symptoms at all. The bone loss progresses silently beneath the gum line. This is why regular check-ups with a periodontist, including probing measurements and periodic imaging, are the most reliable way to detect problems early when they are still treatable.
Accurate diagnosis is the foundation of effective peri-implantitis treatment. Dr. Ahn uses a systematic diagnostic protocol that goes beyond a visual examination to assess the full extent of the disease and identify contributing factors.
Probing around a dental implant measures the depth of the pocket between the gum tissue and the implant surface. Healthy implants typically have probing depths of 3 millimeters or less with no bleeding. Deeper pockets with bleeding on probing indicate inflammation and potential bone loss. Dr. Ahn uses calibrated probes and records measurements at multiple points around each implant to track changes over time. Increasing pocket depths between visits are an early indicator of disease progression, even before bone loss is visible on standard X-rays.
Conventional two-dimensional dental X-rays can reveal bone loss, but they show only a flat view that may underestimate the true extent of the defect. CBCT (cone beam computed tomography) provides a three-dimensional view of the bone around the implant, revealing the exact pattern, depth, and circumferential extent of bone loss. This information is essential for surgical planning because the shape of the bone defect determines whether bone regeneration is possible and what technique will be most effective. CBCT also reveals whether the bone loss is contained (a crater-shaped defect that can be grafted) or horizontal (a flat pattern of bone loss that is more difficult to regenerate).
Treating peri-implantitis without addressing its underlying causes leads to recurrence. Dr. Ahn evaluates each patient for modifiable risk factors including smoking status, oral hygiene practices, history of periodontal disease, diabetes control, occlusal (bite) forces on the implant, and the presence of excess cement or poorly fitting prosthetic components. This comprehensive assessment ensures that the treatment plan addresses both the infection and the factors that allowed it to develop.
Dr. Ahn's philosophy toward failing implants mirrors his approach to natural teeth: save first, replace only when necessary. Not every case of peri-implantitis requires implant removal. Many implants with moderate bone loss can be rescued through a combination of decontamination, infection control, and bone regeneration. The goal is to halt disease progression, eliminate infection, and when possible rebuild the bone that has been lost so the implant can continue to function for years or decades.
This save-first approach requires honest clinical assessment. Dr. Ahn evaluates each case individually and provides straightforward recommendations based on the evidence. When an implant can be saved, he explains exactly what treatment will involve, the expected outcomes, and the long-term maintenance required. When an implant is beyond rescue, he explains why and presents the options for removal, bone grafting, and eventual replacement. Patients are never pushed toward unnecessary treatment or given false hope about an implant that cannot be saved.
As a periodontist who has placed over 5,000 implants, I have a unique perspective on peri-implantitis. I understand not only how implants integrate with bone but also why that integration breaks down. The key to successful peri-implantitis treatment is early detection and a systematic approach: decontaminate the implant surface, eliminate the infection, address the risk factors that caused it, and regenerate bone when the defect pattern is favorable. Many implants that patients have been told need to be removed can actually be saved with the right treatment at the right time. But I am also honest when an implant is beyond saving, because attempting to rescue a hopeless implant wastes time and money.
Treatment for peri-implantitis is staged based on the severity of the disease. Dr. Ahn begins with the least invasive approach and escalates only when necessary. Each treatment level addresses a different stage of the disease.
For early to moderate peri-implantitis, non-surgical debridement involves mechanically cleaning the implant surface and the infected pocket using specialized instruments designed for use on implant surfaces. Unlike natural teeth, implant surfaces are made of titanium and cannot be cleaned with traditional metal scalers, which would scratch the surface and create more sites for bacterial attachment. Dr. Ahn uses titanium curettes, ultrasonic instruments with specialized tips, and air-powder abrasive devices that effectively remove bacterial biofilm without damaging the implant surface. This treatment is combined with local antimicrobial therapy and detailed oral hygiene instruction.
Laser therapy provides an additional level of decontamination that mechanical debridement alone cannot achieve. The laser energy penetrates into the micro-textured surface of the implant, killing bacteria in areas that instruments cannot reach. Laser decontamination also promotes tissue healing and reduces inflammation in the surrounding tissues. Dr. Ahn uses laser therapy in conjunction with mechanical debridement for cases where non-surgical treatment alone is unlikely to fully resolve the infection. The combination of mechanical and laser decontamination provides the most thorough surface decontamination currently available. Learn more about laser periodontal therapy.
When peri-implantitis has caused significant bone loss, surgical intervention may be needed to access the implant surface for thorough decontamination and to rebuild the lost bone. In this procedure, Dr. Ahn reflects a gum tissue flap to expose the implant and the surrounding bone defect. The implant surface is meticulously decontaminated using a combination of mechanical, chemical, and laser methods. Then, bone graft material is placed into the defect around the implant to promote bone regeneration. A collagen membrane may be placed over the graft to contain the material and guide tissue healing. PRF (Platelet-Rich Fibrin) derived from the patient's own blood is used to accelerate healing and enhance bone graft integration. Learn more about bone regeneration.
Surgical bone regeneration is most effective when the bone defect is circumferential (crater-shaped around the implant) rather than horizontal. CBCT imaging reveals the defect pattern before surgery, allowing Dr. Ahn to predict the regenerative potential and set realistic expectations for each case.
When an implant has lost the majority of its surrounding bone, has become mobile, or has failed to respond to previous treatment attempts, removal is the appropriate course of action. Dr. Ahn removes failing implants carefully to preserve as much surrounding bone as possible. The site is then grafted with bone to rebuild the ridge, and after adequate healing (typically 4 to 6 months), a new implant can be placed in the regenerated bone. This staged approach gives the replacement implant the best possible foundation for long-term success.
Understanding the risk factors for peri-implantitis helps patients protect their implant investment and allows Dr. Ahn to create targeted prevention and treatment plans. Research has identified several factors that significantly increase the likelihood of developing peri-implantitis.
Early detection is the key to saving a failing implant. Dr. Ahn provides CBCT-guided evaluations and honest, no-pressure treatment recommendations for peri-implantitis patients in Costa Mesa and throughout Orange County.
Call (714) 549-7030Peri-implantitis treatment costs depend on the severity of the condition, the number of implants affected, and the treatment approach required. At The Loft Dental Studio, we provide detailed cost estimates after your CBCT evaluation and diagnostic workup so you understand exactly what your treatment will involve before proceeding.
Many PPO dental insurance plans cover a portion of peri-implantitis treatment, particularly the non-surgical components. Surgical bone regeneration may be covered under periodontal or oral surgery benefits. Medical insurance may also provide coverage when the condition is documented as medically necessary. Coverage varies significantly by plan and by insurer. Our administrative team contacts your insurance provider before treatment to verify your exact benefits and provide a written estimate of your out-of-pocket cost.
PPO Plans We Accept: Delta Dental, Cigna, MetLife, Guardian, Aetna, United Healthcare, and Blue Cross Blue Shield.
We offer financing through CareCredit, which provides low-interest and interest-free payment plans for patients who prefer to manage costs over time. We also accept FSA (Flexible Spending Account) and HSA (Health Savings Account) funds, allowing you to pay for your peri-implantitis treatment with pre-tax dollars. For more details, visit our Insurance & Payment page.
The Loft Dental Studio is conveniently located in the South Coast Metro area of Costa Mesa, with easy access from communities throughout Orange County. Patients travel from across the region for Dr. Ahn's specialized expertise in treating failing dental implants.
Peri-mucositis is inflammation of the soft tissue surrounding a dental implant without any bone loss. It is the implant equivalent of gingivitis and is reversible with professional cleaning and improved home care. Peri-implantitis is the more advanced stage where inflammation has progressed beyond the soft tissue and is actively destroying the bone that supports the implant. The key difference is bone loss: peri-mucositis involves swollen, bleeding gums but no bone loss on X-rays, while peri-implantitis shows measurable bone destruction around the implant threads. Dr. Ahn uses CBCT 3D imaging and calibrated probing to distinguish between the two conditions and determine the appropriate treatment.
In many cases, yes. The success of implant rescue depends on how much bone has been lost, whether the implant is still stable, the cause of the infection, and how early the condition is caught. When peri-implantitis is detected early with moderate bone loss and the implant remains mechanically stable, treatment options such as non-surgical debridement, laser decontamination, and surgical bone regeneration can halt the disease and restore supporting bone. However, if the implant has lost more than 50 percent of its surrounding bone or has become mobile, removal and replacement may be the only option. Dr. Ahn evaluates each case individually with CBCT imaging to determine whether the implant can be saved.
Peri-implantitis is caused by bacterial infection around the dental implant, but several risk factors increase susceptibility. The most significant risk factors include a history of periodontal disease, inadequate oral hygiene, smoking, uncontrolled diabetes, and excess cement left beneath the gum line during crown placement. Other contributing factors include poorly positioned implants, lack of keratinized gum tissue around the implant, overloading from bite forces, and genetic predisposition. In many cases, multiple factors combine. Dr. Ahn addresses modifiable risk factors as part of every peri-implantitis treatment plan.
Costs vary depending on the severity and treatment approach. Non-surgical debridement with laser decontamination typically ranges from $800 to $1,500 per implant. Surgical bone regeneration around a failing implant ranges from $2,500 to $5,000 depending on the extent of bone loss and graft material needed. If the implant must be removed and replaced, additional costs for implant placement and bone grafting apply. The Loft Dental Studio accepts most major PPO dental insurance plans and offers financing through CareCredit. Our team verifies your benefits before treatment so you understand your out-of-pocket costs.
Many PPO dental insurance plans cover a portion of peri-implantitis treatment, particularly the non-surgical components such as debridement and decontamination. Surgical bone regeneration may be covered under oral surgery or periodontal benefits, though coverage varies by plan. The Loft Dental Studio accepts most major PPO dental insurance plans including Delta Dental, Cigna, MetLife, Guardian, Aetna, United Healthcare, and Blue Cross Blue Shield. Our administrative team contacts your insurance provider before treatment to verify your exact benefits. Financing through CareCredit and FSA/HSA accounts are also accepted.
Warning signs include bleeding when brushing or flossing around the implant, red or swollen gums, pus or discharge from around the implant base, a bad taste or persistent bad breath, receding gums that expose the metal collar, the implant feeling loose when you bite, and pain or discomfort when chewing. Some patients experience no symptoms at all, which is why regular dental check-ups with X-rays are essential. If you notice any of these signs, schedule an evaluation promptly because early intervention significantly improves the chances of saving the implant.
Peri-implantitis is a disease of the tissues surrounding dental implants, and periodontists are the dental specialists specifically trained to diagnose and treat diseases of the supporting structures of teeth and implants. A board-certified periodontist like Dr. Ahn has completed years of advanced residency training in managing infections around implants, performing regenerative bone grafting procedures, and handling the complex surgical techniques required to decontaminate implant surfaces and rebuild lost bone. General dentists may recognize peri-implantitis, but the surgical treatment of moderate to advanced cases requires specialist training that is beyond the scope of general dental education.