Post-Surgical Implant Infection — ORE Part 1 MCQ

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ModerateOral SurgeryPost-Surgical Implant InfectionORE Part 1

A patient presents with a painful, erythematous, and oedematous swelling of the gingiva around a recently placed dental implant (2 weeks post-surgery). Pus is visible at the surgical site. What is the most likely diagnosis?

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Correct answer: B — Post-surgical infection at the implant site

Explanation lettering: B = shown as A · A = shown as B · E = shown as C · C = shown as E

The correct answer is A: post-surgical infection. At 2 weeks post-operatively, the presence of pus, erythema, oedema, and pain constitutes acute bacterial wound infection occurring during the osseointegration phase. Peri-implant mucositis (E) and peri-implantitis (B) are chronic inflammatory/infectious diseases that develop after osseointegration is established (typically weeks to months post-op) and present with different clinical trajectories. Peri-implantitis specifically requires radiographic evidence of progressive marginal bone loss, which is not mentioned. Normal healing (C) excludes suppuration and severe inflammation. Implant rejection (D) is not a standard diagnosis in dental implantology. UK guidance (SDCEP) defines peri-implant mucositis as absence of bone loss, distinguishing it from the acute post-operative infection presenting here.

Reference: SDCEP Prevention and Treatment of Periodontal Diseases in Primary Care: Guidance on treatment of peri-implant mucositis and peri-implantitis (2024). https://www.periodontalcare.sdcep.org.uk/guidance/dental-implants/