Periodontal disease (gum disease) is the leading cause of adult tooth loss and a significant complication for implant treatment. Patients with active periodontitis cannot safely proceed to implants — bacteria in inflamed gum tissue compromise implant integration and increase peri-implantitis risk over the long term. WeCare's two-phase protocol stabilises periodontal disease first, then proceeds to implant placement once the gums are healthy.
When This Combined Plan Applies
Combined periodontal + implant treatment is needed when:
You have visible bleeding gums or active gingivitisPeriodontal pockets >5 mm on probingBone loss documented on X-ray (horizontal or vertical defects)Tooth mobility from periodontal support lossRecent or recurring tooth loss to gum diseaseHistory of periodontal disease with current borderline statusPatients with controlled periodontal disease (under maintenance for years) can proceed directly to standard implant protocol. Patients with active disease need stabilisation first.
Phase 1: Periodontal Stabilisation (Visit 1, 3-5 days)
Day 1 (Arrival + Assessment):
Mercedes transfer to hotelComprehensive periodontal examination: probing depths, bleeding indices, tooth mobility, X-ray analysisBacterial sample collection in cases with severe inflammationDay 2 (Deep Cleaning - Quadrant 1+2):
Local anaesthesiaScaling and root planing of upper teethRemoval of subgingival calculus and bacterial biofilmSometimes supplemented with laser decontaminationAntibiotic prescription (amoxicillin + metronidazole standard)Day 3 (Deep Cleaning - Quadrant 3+4):
Same protocol applied to lower teethEducation on home hygiene tools (Waterpik, interdental brushes, soft electric toothbrush)Photographic documentation of starting stateDay 4 (Final Check + Recommendations):
Re-evaluation of gum statusAdditional scaling if neededTake-home periodontal kit with chlorhexidine mouthwash, special toothpaste, hygiene toolsDay 5 (Departure):
Final reviewFly home with detailed home care plan and return-visit timelineHealing Window (3-6 months at home):
Daily disciplined hygiene with Waterpik + soft brush + interdental cleaningMonthly photo updates to WeCare for monitoringPeriodontal stabilisation confirmed via re-examinationPhase 2: Implant Placement (Visit 2, 4-7 days)
Re-evaluation criteria before proceeding:
Periodontal pockets reduced to under 4 mmNo bleeding on probingStable bone level on X-rayPatient compliance with home hygiene confirmedIf periodontal status not adequately stabilised, additional Phase 1 treatment is required. We do not proceed to implants in patients with active disease — outcome would be compromised.
Standard implant protocol: Once stabilised, implant placement follows our standard 4-7 day visit protocol depending on case complexity.
Healing window (3 months) + Final crown visit (2-3 days) as per standard implant treatment.
Why Sequence Matters
Implants placed in active periodontitis have:
2-3× higher early failure rateSignificantly higher peri-implantitis risk over 10+ yearsReduced long-term successHigher rate of bone loss around implant collarImplants placed in stabilised periodontal patients have:
Success rates approaching general population (95% over 5 years)Long-term peri-implantitis risk slightly elevated but manageableLifelong implant survival possible with maintenanceThe 3-6 month delay for stabilisation is non-negotiable for long-term success.
Materials and Brands
Phase 1 Periodontal:
Hand instruments + ultrasonic scalers (Cavitron / EMS)Optional laser decontamination (PerioLase MVP-7)Chlorhexidine 0.12% mouthwash (Peridex / Curasept)Local antibiotic delivery (Arestin) for resistant pocketsBio-Oss® bone graft for severe defects requiring regenerationPhase 2 Implants:
Straumann SLActive® preferred for periodontal patients (faster integration)Nobel Biocare TiUltra® for multi-zone soft-tissue health at collarTissue-level implants for thin biotype patientsMaterials Used
Periodontal phase: Bio-Oss® for regenerative defects, Bio-Gide® collagen membranes when guided tissue regeneration applies, Arestin local antibiotics for non-responsive pockets.
Implant phase: Same premium European brands with surface technology optimised for periodontally-prone patients (Straumann SLActive®, Nobel Biocare TiUltra®).
Long-term Maintenance
After both phases complete, periodontally-prone patients require ongoing vigilance:
Every 3-4 months for first year: Professional cleaning + periodontal screening at WeCare or your home dentist. Critical for first-year peri-implantitis prevention.
Every 4 months thereafter: Lifelong professional cleanings (vs 6 months for non-periodontitis patients). Annual peri-implantitis screening.
Daily home care:
Soft-bristle electric toothbrush (Sonicare)Daily Waterpik / oral irrigator (non-negotiable)Interdental brushes for tight spacesAntibacterial mouthwash for first 6 months post-implantAnnual: Panoramic X-ray + clinical exam. Optional 3D CBCT every 5 years for comprehensive assessment.
Risks and Honest Discussion
Periodontal phase risks:
Insufficient response — some patients have aggressive forms of periodontitis requiring specialist (periodontist) referralTooth loss during stabilisation — severely compromised teeth may need extractionCost of regenerative procedures if bone defects existImplant phase risks (in periodontally-prone patients):
Higher long-term peri-implantitis risk vs general populationNeed for more frequent maintenancePotential late implant failure 10-15+ years outWeCare's combined protocol mitigates these through careful sequencing, premium materials, and disciplined long-term maintenance support. Patients understand the elevated long-term commitment.
What to Send Us
WhatsApp +90 551 086 83 68 with:
Recent panoramic X-ray (OPG)Recent periodontal charting from your home dentist if availablePhotographs of your gums (close-up smile)List of teeth lost to gum disease (when, how)Antibiotic historyCurrent oral hygiene routineWithin 24 hours we send a written assessment of whether you are an implant candidate, what periodontal stabilisation is needed first, total timeline across both phases, and individual quotation.
Bereit, Ihre Behandlung zu beginnen?
Kostenloser schriftlicher Behandlungsplan innerhalb von 24 Stunden. Senden Sie Ihr Panorama-Röntgenbild und 5 intraorale Fotos per WhatsApp.
WhatsApp +90 551 086 83 68