Peri-Implantitis Treatment in San Jose, CA
 Peri-implantitis is inflammation and progressive bone loss around a dental implant, and our oral and maxillofacial surgeons in San Jose, CA treat both early cases (where the implant can often be saved) and advanced cases (where surgical reconstruction is needed).
If your dentist has diagnosed peri-implantitis, or you’re searching for “infected implant” or “implant feels loose,” you’re in the right place. This condition is highly treatable when caught early, and early intervention is the difference between saving the implant and replacing it.
Peri-implantitis is implant-specific. It looks similar to gum disease around a natural tooth, but the treatment is different because an implant doesn’t respond to scaling the way a tooth does, and the bone around an implant heals on a different timeline. Treating peri-implantitis like routine dental implant cleaning often misses the point.
At South Valley Oral and Facial Surgery, we approach each case based on what the imaging shows. Mild peri-implantitis with limited bone loss is often managed conservatively. Moderate cases call for surgical access, decontamination of the implant surface, and bone regeneration. Severe cases may require failed implant repair including removal and eventual replacement. We see patients from San Jose, Gilroy, and Los Banos across the full spectrum.
On This Page
What Is Peri-Implantitis?
 Peri-implantitis is inflammation of the tissues surrounding a dental implant, accompanied by progressive loss of the bone that holds the implant in place. It is implant-specific and differs from peri-implant mucositis, which is inflammation without bone loss and is generally reversible. Once bone loss starts, the condition is harder to reverse and the goal shifts to stopping the progression and rebuilding what has been lost.
The mechanism is similar to periodontitis around natural teeth. Bacteria accumulate at the implant-gum interface, inflammation follows, and over time the bone begins to recede. The reason peri-implantitis is treated differently is that implants don’t have the periodontal ligament that surrounds natural teeth, which means the local immune response and the healing dynamics work differently. Treatment has to account for that.
Symptoms to Watch For
Peri-implantitis can develop quietly. The earliest signs are easy to miss, which is why dental check-ups around implants matter. Common symptoms include:
| • |
Bleeding When Brushing or Flossing – The gum tissue around the implant bleeds where it didn’t used to
|
| • |
Redness and Swelling – The gum margin looks puffy or red rather than firm and pink
|
| • |
Pus or Discharge – A clear sign of active infection, often along with a bad taste
|
| • |
Receding Gum Around the Implant – The crown starts to look longer than the surrounding teeth
|
| • |
Bone Loss on X-Ray – Your dentist may identify this before you notice anything wrong, which is why routine implant imaging matters
|
| • |
Implant Mobility – A late-stage sign. A loose implant is rarely salvageable in place |
If you notice any of these around an implant, an evaluation is worthwhile sooner rather than later.
What Causes Peri-Implantitis
Several factors raise the risk, often in combination:
| • |
Inadequate Home Care – Implants need consistent daily cleaning to keep the gum-implant interface healthy
|
| • |
Residual Cement – Cement left behind after crown placement can trap bacteria and trigger inflammation, which is one of the most common causes we see
|
| • |
Smoking – Smokers have significantly higher peri-implantitis rates and worse treatment outcomes
|
| • |
Uncontrolled Diabetes – Elevated blood sugar impairs the healing response and accelerates tissue breakdown
|
| • |
Occlusal Overload – A bite force imbalance can stress the implant and contribute to bone loss
|
| • |
History of Periodontal Disease – Patients who lost their natural teeth to periodontitis are at higher risk for peri-implantitis around their replacements |
Knowing which factors are at play in your case helps shape the treatment plan and the long-term maintenance strategy.
Your Peri-Implantitis Treatment Team in San Jose
Peri-implantitis sits at the intersection of periodontics and oral surgery. Conservative management can sometimes be handled by your general dentist or periodontist. Surgical management, especially when bone regeneration or implant removal is involved, calls for an oral and maxillofacial surgeon with regular implant experience. Both of our surgeons fit that description.
Dr. Joseph McMurray has been practicing oral and maxillofacial surgery for more than 35 years and brings additional experience from 11 years with the U.S. Navy, including as fleet oral surgeon aboard the USS Nimitz. Dr. Arian Chehrehsa is dual board-certified in Oral & Maxillofacial Surgery and Anesthesiology, with specific expertise in complex implant cases and full-arch reconstruction. He also leads regional study clubs on full-arch implant surgery. Both surgeons routinely handle peri-implant surgery, including cases that involve bone grafting, sinus involvement, or eventual implant replacement.
The Peri-Implantitis Treatment Process
 Peri-implantitis treatment is staged based on severity. Early cases get conservative care first. Moderate to severe cases move to surgical management. The CBCT scan at the consultation tells us which path your case calls for.
Step 1 – Evaluation and 3D Imaging
We start with a clinical exam, periodontal probing around the implant, and a CBCT scan. The 3D image shows us the exact pattern of bone loss, whether the implant itself remains stable, and whether adjacent anatomy (sinus, nerve, neighboring teeth) factors into the plan. This is where the case sorts into early, moderate, or advanced.
Step 2 – Non-Surgical Therapy (Early Cases)
For early peri-implantitis with minimal bone loss, we typically start with non-surgical therapy. That includes professional cleaning around the implant using instruments designed for the implant surface, antimicrobial irrigation, and sometimes a course of antibiotics or local antimicrobial agents. We coach you on improved home care and may recommend additional aids like interdental brushes or a water flosser. We reassess in 2 to 3 months. Many early cases respond well to this approach alone.
Step 3 – Surgical Access and Decontamination (Moderate Cases)
When non-surgical therapy isn’t enough, or when imaging shows moderate bone loss from the start, we move to surgical management. We open a small flap to expose the implant and the bony defect, debride the granulation tissue, decontaminate the implant surface with a combination of mechanical and chemical methods, and prepare the site for regeneration.
Step 4 – Bone Regeneration
If the defect is suitable for regeneration, we place a bone graft with a barrier membrane to rebuild what was lost around the implant. The flap is then closed with sutures. Healing takes 4 to 6 months before we reassess the bony recovery.
Step 5 – Implant Removal (Advanced Cases Only)
If the implant is mobile, severely contaminated, or surrounded by bone loss too advanced to regenerate, the best path is often removal followed by site healing and eventual replacement. This is where peri-implantitis treatment overlaps with failed dental implant repair. For upper-jaw cases with significant bone loss, a sinus lift may also be part of the reconstruction.
Step 6 – Long-Term Maintenance
After active treatment, peri-implantitis cases need closer follow-up than routine implants. We typically recommend professional implant maintenance every 3 months for the first year, then reassess. We coordinate with your general dentist on long-term implant care so the implant has the best chance of stable function going forward.
Benefits of Treating Peri-Implantitis Early
Peri-implantitis is one of those conditions where timing changes the outcome more than almost any other factor. The earlier we treat it, the more options you have and the better the long-term result.
| • |
Saves the Implant – Early peri-implantitis is often reversible or arrestable with non-surgical or minimally surgical care, and the implant stays in place. This is the path we prefer whenever the imaging supports it
|
| • |
Preserves Bone – Bone loss around an implant doesn’t come back on its own. Bone you preserve through early treatment is bone our team doesn’t have to rebuild later with grafting
|
| • |
Reduces Risk to Neighboring Teeth and Implants – The bacteria that drive peri-implantitis can affect adjacent restorations if left untreated, which is why we evaluate the whole area with CBCT at the consultation, not just the affected implant
|
| • |
Lower Cumulative Cost – Conservative early treatment is far less expensive than removal, grafting, and implant replacement
|
| • |
Shorter Total Treatment Time – Catching it early often means a few appointments rather than a year-long reconstruction, and our 3-month follow-up cadence catches recurrences before they progress
|
| • |
Better Long-Term Comfort – Active peri-implantitis is often uncomfortable, and treatment relieves that fairly quickly |
The frustrating part about peri-implantitis is that the early stages are often painless. Patients who get regular dental check-ups and implant-specific monitoring tend to catch it early. Patients who haven’t seen a dentist in a while often present with more advanced disease.
Why Choose Our Team for Peri-Implantitis Treatment
Peri-implantitis falls on the spectrum from a maintenance issue to a complex surgical case, and you want a team that handles all of it.
| • |
Two Board-Certified OMFS Surgeons – Dr. McMurray and Dr. Chehrehsa manage the full range, including cases that need implant removal and full reconstruction
|
| • |
In-House Sedation – Surgical peri-implant cases are often done with IV sedation, handled by our own anesthesiology-trained team
|
| • |
3D CBCT Imaging – Every case gets a 3D scan to map the bone defect precisely before treatment starts
|
| • |
Coordinated Care – We work alongside your general dentist or periodontist on conservative cases and take the lead on surgical cases
|
| • |
Three Office Locations – Patients across the South Bay and Central Valley can choose between San Jose, Gilroy, and Los Banos for follow-up visits, which matters because peri-implantitis follow-up is frequent in the first year |
We also avoid an all-or-nothing posture on peri-implantitis. Not every case needs surgery, and not every case can be managed conservatively. We tell you which category your case falls into based on the imaging, not based on what we’d prefer to do.
Peri-Implantitis Treatment Cost and Financing
Cost depends heavily on what stage your case is in. Non-surgical management of early peri-implantitis is a smaller fee, often handled across a few appointments. Surgical access with bone regeneration is more significant. Implant removal, bone grafting, and eventual replacement is the largest end of the range. We provide a written estimate after the consultation and CBCT so you know what to expect.
Insurance handles peri-implantitis variably. Some dental plans cover the periodontal-style aspects of treatment (scaling, antimicrobial therapy). Some cover bone grafting around an implant. Medical insurance occasionally covers a portion for severe cases involving significant jaw reconstruction. We verify your specific coverage before treatment and walk you through what we expect insurance to pay. Financing through third-party lenders is available. More on our insurance and financing options.
Schedule a Peri-Implantitis Consultation
If your dentist has diagnosed peri-implantitis, or you’re noticing bleeding, swelling, or discomfort around an implant, a consultation and a 3D scan are the right next step. The earlier we evaluate, the more we can usually do. Call us at 408-479-9449 or request an appointment online to get started. Our San Jose office is at 5595 Winfield Blvd, Suite 202. We also see patients at our Gilroy and Los Banos offices.
Frequently Asked Questions
Will I lose my implant if I have peri-implantitis?
Not necessarily. Early-stage peri-implantitis with mild bone loss is often reversible or stoppable, and the implant stays in place. Moderate cases can frequently be salvaged with surgical decontamination and bone regeneration. Implant loss is mostly a concern in advanced cases with severe bone loss or implant mobility. The CBCT scan at the consultation tells you which category your case falls into.
Is peri-implantitis the same as gum disease?
It’s related but not the same. Both involve bacterial inflammation and bone loss, but peri-implantitis specifically affects implants, and the tissue anatomy around an implant differs from a natural tooth. Implants don’t have a periodontal ligament, which changes how the infection progresses and how it responds to treatment. Treating peri-implantitis with a standard gum disease protocol often misses the point.
Does peri-implantitis treatment hurt?
Non-surgical treatment is comparable to a deep cleaning around a natural tooth, and most patients tolerate it with topical or local anesthesia alone. Surgical treatment is done under local anesthesia, with IV sedation available, and the post-op discomfort is similar to a standard implant placement. Most patients return to normal activity within a few days.
How long does peri-implantitis treatment take?
Non-surgical therapy is usually 1 to 3 appointments over a few months, with a reassessment to confirm the response. Surgical treatment with bone regeneration takes one surgical visit followed by 4 to 6 months of healing before reassessment. Cases that require implant removal and replacement run 8 to 12 months from start to finish, and at that stage the workflow overlaps with failed dental implant repair.
What caused my peri-implantitis?
It’s usually a combination rather than a single cause. The most common factors we see are inadequate home care around the implant, residual cement left from the original crown placement, smoking, uncontrolled diabetes, and a history of periodontal disease before the implant was placed. We’ll discuss your specific risk factors at the consultation so we can address them as part of treatment.
Can peri-implantitis come back after treatment?
Yes, which is why long-term maintenance matters. We typically recommend professional implant maintenance every 3 months for the first year after treatment, then reassess. Patients who stop smoking, control their blood sugar, and maintain consistent home care around their implants have substantially lower recurrence rates than those who don’t.
Is non-surgical treatment ever enough on its own?
For early peri-implantitis with limited bone loss, yes, fairly often. We start with non-surgical therapy when the imaging supports it and reassess after 2 to 3 months. If the response is good, no further surgical care may be needed beyond ongoing maintenance. If the inflammation persists or the bone loss continues, that’s our cue to move to surgical management.
Does insurance cover peri-implantitis treatment?
Coverage varies by plan and by which part of the treatment is being billed. The periodontal-therapy components (scaling, debridement, antimicrobials) are often covered partially by dental plans. Bone grafting around an implant is sometimes covered. Implant removal and replacement may be covered to varying degrees, with medical insurance occasionally contributing for severe cases. We verify your specific benefits before treatment. More on our insurance and financing options. |
