Advanced peri-implantitis treatment by Yale-trained, board-certified periodontist Dr. Chanook David Ahn. LANAP laser therapy, implant surface decontamination, and bone grafting to save failing dental implants. Located in Costa Mesa, just 15 minutes from Huntington Beach via I-405 S.
Peri-implantitis is a destructive inflammatory condition that affects the tissues surrounding a dental implant, causing progressive loss of the supporting bone. Unlike a natural tooth cavity that damages the tooth itself, peri-implantitis attacks the foundation that holds the implant in place. Left untreated, it leads to implant loosening and ultimately implant failure, requiring removal of the implant and complex reconstructive procedures. For Huntington Beach residents who have invested in dental implants, understanding this condition and seeking prompt treatment from a board-certified periodontist is essential for protecting that investment.
It is important to distinguish peri-implantitis from its precursor, peri-implant mucositis. Peri-implant mucositis is inflammation limited to the soft tissue (gums) around the implant without any bone loss. It is the implant equivalent of gingivitis and is fully reversible with professional cleaning and improved oral hygiene. Peri-implantitis, by contrast, means the infection has penetrated deeper, triggering the body's immune response to destroy the bone around the implant threads. Once bone loss begins, it does not reverse on its own and requires professional intervention to halt the destructive process.
Research indicates that peri-implantitis affects up to 20 percent of dental implant patients within 5 to 10 years after implant placement. The condition can progress silently, with patients often unaware of the problem until significant bone loss has already occurred. This is why regular maintenance visits with a periodontist who monitors implant health through probing measurements and radiographic comparisons are so critical. At The Loft Dental Studio, Dr. Chanook David Ahn has placed more than 5,000 dental implants and has extensive experience diagnosing and treating peri-implantitis at every stage, from early mucositis through advanced bone loss requiring surgical intervention.
Why Peri-Implantitis Requires a Specialist: Peri-implantitis treatment involves decontaminating the implant surface, eliminating bacterial biofilm from threads that are not accessible with standard cleaning instruments, and regenerating lost bone. These are highly specialized procedures that require advanced surgical training, specific instrumentation, and a deep understanding of implant biology. A board-certified periodontist like Dr. Ahn has completed 3 additional years of residency training focused specifically on these tissues and procedures.
Peri-implantitis often develops gradually, and many patients do not realize there is a problem until the disease has progressed significantly. Knowing the warning signs allows you to seek evaluation early, when treatment is most effective and the chances of saving the implant are highest.
Certain factors increase a patient's susceptibility to developing peri-implantitis. Understanding these risk factors helps both in prevention and in identifying patients who need closer monitoring after implant placement.
Accurate diagnosis of peri-implantitis requires more than a visual examination. Dr. Ahn employs a systematic diagnostic approach that identifies the condition at its earliest stages and accurately assesses its severity to determine the most appropriate treatment strategy.
Using a calibrated periodontal probe, Dr. Ahn measures the depth of the sulcus (pocket) around each implant. Healthy implants typically have probing depths of 3 millimeters or less. Depths exceeding 5 millimeters, especially when accompanied by bleeding or suppuration upon probing, indicate peri-implant disease. Serial measurements taken at each maintenance visit allow tracking of any changes over time.
Periapical X-rays and, when indicated, CBCT 3D scans reveal the level of bone around the implant threads. Dr. Ahn compares current images to baseline radiographs taken at the time of implant placement or prosthetic loading. Any progressive bone loss beyond the initial physiologic remodeling (approximately 1 to 1.5 millimeters of crestal bone loss in the first year) is concerning and warrants further investigation. A CBCT scan provides a three-dimensional view that reveals the full extent of bone loss around the implant, including buccal and lingual defects that standard two-dimensional X-rays may not capture.
Bleeding on probing around an implant is one of the earliest and most reliable indicators of peri-implant inflammation. The presence of suppuration (pus) confirms active infection. Dr. Ahn records these findings systematically at every evaluation to track disease progression or resolution after treatment.
Many patients come to us after being told their implant is failing and needs to be removed. In my experience, a significant number of these implants can be saved with the right treatment approach. The key is accurate diagnosis of how much bone remains, whether the bone defect morphology is favorable for regeneration, and whether the implant surface can be effectively decontaminated. Having placed over 5,000 implants, I understand implant biology from both the placement and the salvage perspectives. That dual expertise allows me to make better treatment decisions about which implants can be saved and what the long-term prognosis looks like after treatment.
Treatment for peri-implantitis is tailored to the severity of the disease, the pattern of bone loss, and the individual patient's risk factors. Dr. Ahn develops a customized treatment plan for each case, ranging from conservative non-surgical approaches for early disease to advanced surgical regeneration for more severe cases.
For early-stage peri-implantitis or peri-implant mucositis, non-surgical treatment may be sufficient. This involves mechanical debridement of the bacterial biofilm from the implant surface using specialized instruments designed to clean implant threads without scratching the titanium surface. Ultrasonic scalers with plastic or carbon fiber tips, titanium curettes, and air-abrasive devices are used to disrupt and remove the bacterial biofilm. Antimicrobial agents such as chlorhexidine irrigation, locally delivered antibiotics placed directly into the pocket, or systemic antibiotics may be used as adjuncts to mechanical cleaning. Non-surgical debridement is most effective in the earliest stages of disease and is combined with patient education on improved home care techniques.
The LANAP (Laser-Assisted New Attachment Procedure) protocol, adapted for implants as LAPIP (Laser-Assisted Peri-Implantitis Protocol), represents a significant advancement in peri-implantitis treatment. Dr. Ahn uses the PerioLase MVP-7 Nd:YAG laser, a specifically designed wavelength that selectively targets diseased tissue and bacteria while preserving healthy tissue and bone.
During the LAPIP procedure, the laser fiber is inserted into the pocket around the affected implant. The laser energy destroys the bacterial colonies and infected granulation tissue without damaging the implant surface. A critical advantage of the LANAP laser is its ability to decontaminate the textured implant surface, reaching bacteria harbored within the microscopic threads and roughened surfaces that mechanical instruments cannot fully access. The laser also creates a thermal blood clot that seals the pocket, providing a stable environment for healing and new bone formation.
Benefits of LANAP laser therapy for peri-implantitis include minimally invasive treatment without scalpel incisions or sutures, selective removal of diseased tissue while preserving healthy tissue, superior decontamination of the implant surface, reduced post-operative pain and swelling compared to traditional surgery, faster healing and recovery time, and the potential for bone regeneration around the treated implant. Learn more about our LANAP laser treatment capabilities.
For moderate to severe peri-implantitis with significant bone loss, open flap surgical access may be necessary to fully decontaminate the implant surface and regenerate lost bone. Dr. Ahn carefully elevates the gum tissue to expose the implant threads and the bone defect. The implant surface is thoroughly decontaminated using a combination of mechanical cleaning, chemical agents, and laser energy to remove all traces of bacterial biofilm.
Once the implant surface is clean, bone grafting material is placed into the defect to provide a scaffold for new bone formation. The type of graft material and regenerative membranes used depend on the size, shape, and location of the bone defect. Contained defects with walls of remaining bone on multiple sides respond best to grafting because the surrounding bone provides a framework for regeneration. Dr. Ahn uses PRF (Platelet-Rich Fibrin) therapy derived from the patient's own blood to enhance the grafting procedure, delivering concentrated growth factors directly to the surgical site to accelerate bone and soft tissue healing. Learn more about our bone grafting and regeneration services.
When peri-implantitis has destroyed so much bone that the implant lacks adequate support, when the implant is frankly mobile, or when the defect pattern is not conducive to successful regeneration, implant removal may be the most appropriate treatment. Removing a failing implant prevents ongoing bone destruction and infection, preserving as much remaining bone as possible for future implant replacement. After removal, Dr. Ahn typically performs bone grafting at the extraction site to rebuild the ridge, followed by placement of a new implant once the site has fully healed, usually in 4 to 6 months.
Peri-implantitis treatment requires a combination of skills that are central to periodontal specialty training: surgical access to deep tissue, implant surface decontamination, bone grafting and guided tissue regeneration, and management of soft tissue around implants. A board-certified periodontist has completed 3 additional years of residency training beyond dental school focused specifically on these procedures.
Dr. Chanook David Ahn brings unique qualifications to peri-implantitis treatment. Having placed more than 5,000 dental implants over his career, he understands implant biology from the perspective of both placement and salvage. He knows which implant systems, surface textures, and connection types respond best to different decontamination protocols. His Yale residency training provided rigorous education in bone biology, tissue regeneration, and the research behind current treatment approaches. As a LANAP-certified provider, he offers the most advanced laser technology for implant salvage in addition to conventional surgical techniques.
Board Certification Matters: Board certification from the American Board of Periodontology requires passing a rigorous written and oral examination that tests mastery of the specialty. Only a fraction of practicing periodontists achieve board certification. It represents the highest level of demonstrated competency in periodontal diagnosis and treatment, including the management of peri-implant diseases.
If you are experiencing bleeding, swelling, or discomfort around a dental implant, early evaluation is critical. Dr. Ahn provides comprehensive assessment and a customized treatment plan to save your implant.
Call (714) 549-7030The cost of peri-implantitis treatment depends 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 evaluation so you understand your investment before treatment begins.
Many PPO dental insurance plans provide partial coverage for peri-implantitis treatment because it is considered medically necessary to preserve existing dental work and prevent further bone loss. Coverage varies by plan but typically falls under the surgical periodontal benefits category. Our administrative team verifies your benefits before treatment so you know your out-of-pocket costs in advance.
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. We also accept FSA (Flexible Spending Account) and HSA (Health Savings Account) funds. For more details, visit our Insurance & Payment page.
The Loft Dental Studio is conveniently located in the South Coast Metro area of Costa Mesa, approximately 15 minutes from Huntington Beach. From Huntington Beach, take I-405 South to the Fairview Road exit. Turn right onto Fairview Road, then turn left onto Airway Avenue. Our office is located on the right at 3151 Airway Ave, Suite F-103, within the South Coast Metro business district. The drive is straightforward with easy freeway access and ample parking at our building.
Prevention is always preferable to treatment. The following strategies significantly reduce your risk of developing peri-implantitis and help protect your investment in dental implants for the long term.
Peri-implant mucositis is inflammation of the soft tissue surrounding a dental implant without any bone loss. It is the implant equivalent of gingivitis and is fully reversible with professional cleaning and improved home care. Peri-implantitis is the more advanced condition where the inflammation has progressed beyond the soft tissue and is actively destroying the bone that supports the implant. Once bone loss occurs, it cannot reverse on its own and requires professional intervention. Think of peri-implant mucositis as the warning stage and peri-implantitis as the disease stage. Catching the problem at the mucositis stage through regular maintenance visits allows treatment before permanent bone damage occurs.
Peri-implantitis can be effectively treated and the disease process arrested, but the success of treatment depends on the severity of bone loss at the time of diagnosis and the patient's commitment to ongoing maintenance. In early to moderate cases, treatment with LANAP laser therapy or surgical debridement combined with bone grafting can eliminate the infection, regenerate lost bone, and restore the implant to health. In advanced cases where significant bone loss has occurred, the goal shifts to halting further destruction and stabilizing the implant. The key factors for successful treatment are early detection, thorough decontamination of the implant surface, elimination of risk factors such as smoking, and strict adherence to maintenance visits every 3 to 4 months after treatment.
The LANAP laser protocol adapted for implants, called LAPIP (Laser-Assisted Peri-Implantitis Protocol), uses a specialized PerioLase MVP-7 Nd:YAG laser to treat the infected tissue around a failing implant. The laser fiber is inserted into the pocket around the implant, where it selectively destroys diseased tissue and bacteria while leaving healthy tissue intact. The laser energy also decontaminates the implant surface, removes the bacterial biofilm that conventional cleaning cannot fully reach, and stimulates the formation of a stable blood clot that promotes bone regeneration. Unlike traditional surgery, LANAP does not require cutting or suturing, results in less post-operative pain and swelling, and allows faster healing. Dr. Ahn is LANAP-certified and has treated hundreds of peri-implantitis cases using this protocol.
Warning signs of a failing dental implant include bleeding when you brush or floss around the implant, redness or swelling of the gum tissue surrounding the implant, a bad taste or persistent odor coming from the implant area, pus or discharge when pressure is applied to the gum around the implant, increasing pocket depth measured during dental checkups, and visible bone loss on X-rays compared to previous images. In advanced stages, the implant itself may feel loose or mobile. If you notice any of these signs, schedule an evaluation as soon as possible. Early intervention dramatically improves the chances of saving the implant. Do not wait for pain, as peri-implantitis can destroy significant bone before you experience discomfort.
Peri-implantitis treatment costs vary depending on the severity of the disease and the treatment approach required. Non-surgical debridement with antimicrobial therapy typically ranges from $500 to $1,500 per implant. LANAP laser therapy for peri-implantitis generally costs $1,500 to $3,000 per implant. Surgical access with bone grafting ranges from $2,500 to $5,000 per implant depending on the extent of bone loss and grafting material needed. Many PPO dental insurance plans provide partial coverage for peri-implantitis treatment because it is medically necessary to preserve existing dental work. The Loft Dental Studio accepts most major PPO plans, offers financing through CareCredit, and accepts FSA and HSA funds. Our team verifies your benefits before treatment so you understand your costs in advance.
Preventing peri-implantitis requires a combination of professional maintenance and diligent home care. Schedule professional cleanings and implant maintenance visits every 3 to 6 months, as recommended by your periodontist. At home, brush twice daily with a soft-bristle or electric toothbrush, paying careful attention to the gum line around each implant. Use an interdental brush, floss threader, or water flosser to clean between implants and under bridges daily. If you smoke, quitting is one of the most important steps you can take, as smoking dramatically increases peri-implantitis risk. If you have diabetes, maintaining good blood sugar control reduces inflammation throughout the body, including around implants. Having adequate keratinized (firm, attached) gum tissue around your implants also reduces risk, which is something Dr. Ahn evaluates and can address with soft tissue grafting if needed.