Dental Implants in Sacramento: What a 2025 Review Found About Implant Surfaces and Treating Gum Disease Around Implants
If you have dental implants, the health of the gum and bone around them matters just as much as the implant itself. When gum disease develops around an implant, dentists call it peri-implantitis: inflammation plus progressive bone loss around an implant that is already fused to the bone. Left alone, it can eventually cost you the implant. A 2025 systematic review asked a question patients rarely hear about but dentists think about a lot: does the surface of the implant — smooth or rough — change how well surgical treatment for peri-implantitis works over the long term? The answer turns out to matter for how your dentist plans treatment, and it is worth understanding before you ever need it.
What Peri-Implantitis Is, in Plain Language
A healthy implant sits quietly in bone, with firm gum tissue sealing around it. Peri-implantitis breaks that seal. Bacteria collect in a biofilm on the implant surface, the gum becomes inflamed and bleeds, and the bone supporting the implant gradually recedes. You may notice bleeding when you brush, swelling, a bad taste, or an implant that feels different — or you may notice nothing at all until a routine X-ray shows bone loss. That silent progression is why implant patients need regular checkups with probing measurements and X-rays, not just a quick look. Caught early, peri-implantitis is far easier to manage than after years of bone loss.
Why Implant Surface Matters at All
Implant surfaces are not all alike. Some implants are machined smooth, often called turned surfaces. Others are deliberately roughened — sandblasted, acid-etched, or anodized — to help bone grip the implant more strongly during healing. That roughness is a real advantage when an implant is healing: more surface area for bone to lock onto usually means stronger early integration. But the same texture that helps bone attach can also give bacteria more places to hide once gum disease starts, and it can make the surface harder to clean during treatment. The 2025 review set out to test whether that trade-off shows up in long-term treatment results.
What the Researchers Did
The review team, led by Gardelis and colleagues at the University of Geneva, searched PubMed, Embase, and the Cochrane Library for human studies of surgical peri-implantitis treatment with at least three years of follow-up, where the implant surface type was reported. They included 17 clinical studies — prospective and retrospective cohorts, one randomized trial, and case series — and compared outcomes by surface type (smooth turned, rough modified, or mixed) and by surgical approach (reconstructive, using bone grafts and membranes to rebuild support, versus non-reconstructive, such as open flap cleaning without rebuilding bone). Because the studies varied so much in surfaces, techniques, and measurements, the authors summarized the results narratively rather than pooling them into a single number.
What They Found: Rough Surfaces Fared Worse After Treatment
The headline finding was consistent: implants with rough, modified surfaces generally had a higher risk of peri-implantitis coming back after surgical treatment, and a higher risk of implant loss, compared with smooth, machined surfaces. In other words, the surface that helps an implant heal well in the beginning can work against it once disease has taken hold, because bacteria cling to the rough texture and thorough cleaning is harder to achieve. Smooth-surface implants, by contrast, tended to show more favorable long-term treatment outcomes in the studies reviewed. This does not mean rough-surface implants are bad — they are widely used and usually succeed — but it does mean that if peri-implantitis develops, the surface type becomes part of the treatment conversation.
What They Found: Rebuilding Bone Helped More
The second finding is encouraging for patients facing surgery. Reconstructive approaches — surgery that cleans the area and then rebuilds lost support with bone graft material and a protective membrane — generally produced more favorable outcomes than non-reconstructive surgery alone. That makes intuitive sense: cleaning stops the disease process, while grafting gives the implant something to stand in again. The review also notes important honesty about the evidence: the overall certainty is low, because the studies were small, varied in methods, and sometimes inconsistent. So these are trends to guide planning, not guarantees about any individual implant.
What This Means for Sacramento Implant Patients
First, prevention is still the best treatment. Daily cleaning around implants, including interdental brushes your hygienist can size for you, plus regular professional maintenance, keeps biofilm from gaining a foothold. Second, if you are told you have peri-implantitis, ask your dentist two questions: what surface type is my implant, and would a reconstructive approach make sense in my case? Third, remember the broader context the review cites: long-term studies report implant survival typically exceeding 90 percent over five to ten years, so prompt, well-planned treatment gives a troubled implant its best chance to join that majority.
At Expert Dental Group, Dr. Leila Nikpour is a prosthodontist with more than 15 years of dentistry experience, and the practice has placed 2,500+ dental implants. A prosthodontist in Roseville can evaluate an implant with bone loss, review what surface and grafting options fit your case, and explain the plan in plain language before any surgery. In-house 3D CBCT imaging maps the remaining bone precisely, which matters when deciding whether reconstructive surgery is feasible.
Visit Expert Dental Group
Expert Dental Group is located at 5070 Foothills Blvd, Suite 2, Roseville, CA 95747. Call (916) 888-1646 to schedule your free implant consultation. Hours: Monday–Friday 9–6, Saturday 9–1.
References
- Gardelis P, Giannopoulou C, Stavropoulos A, Zekeridou A. Impact of implant surface modifications on long-term outcome of surgical peri-implantitis treatment: a systematic review. Frontiers in Dental Medicine. 2025;6:1661369. DOI: 10.3389/fdmed.2025.1661369. PMID: 41069513. PubMed: https://pubmed.ncbi.nlm.nih.gov/41069513/
Frequently Asked Questions
What is peri-implantitis?
Peri-implantitis is gum disease around a dental implant: inflammation plus progressive bone loss around an implant that has already fused to the bone. Without treatment it can eventually lead to implant loss.
Do rough implant surfaces cause peri-implantitis?
Not exactly. The review found rough surfaces were linked to worse outcomes after surgical treatment — more recurrence and implant loss — compared with smooth surfaces, but surface type is only one factor alongside cleaning, gum health, and overall health.
What is reconstructive surgery for peri-implantitis?
It is surgery that cleans the diseased area and then rebuilds lost bone support with graft material and a protective membrane, rather than cleaning alone. The review found reconstructive approaches generally gave more favorable outcomes.
How do I know if I have peri-implantitis?
Often you do not, at first. Bleeding when brushing, swelling, or a bad taste can be signs, but early bone loss is usually found at checkups through probing measurements and X-rays — which is why regular implant maintenance visits matter.
Can an implant with peri-implantitis be saved?
Often, yes — especially when caught early and treated with a well-planned surgical approach. Your dentist will consider the implant surface, how much bone remains, and whether reconstructive surgery fits your case.