Management of an advanced periimplantitis

Situation

Severe bone resorption, gingival inflammation & recession around implant #46.

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Flap was reflected to clean the contaminated implant surface. Large bone defects were found.

Each contaminated implant thread was cleaned by i Brushing with copious water for 3 minutes.

With i Brushing, deep below the crestal area may be cleaned.

New rough surface has been created. i Brushing is only recommended for 1 to 3 exposed threads, as it takes 3 minutes for each thread.

Laser treatment was additionally applied to the surface to eliminate remaining plaques or harmful toxins.

Tetracycline was applied for detoxification for 5 minutes.

The autogenous bone was harvested using ACM drill at 50rpm without water.

Harvested bone chips were applied to the defect.

The wound closure was achieved with suture.

Postoperative radiographic view.

1 year postop. Soft tissue around implants has been maintained without any inflammation signs.

1 year follow of crestal bone level shows no further bone loss.