Situation
Severe bone resorption, gingival inflammation & recession around implant #46.
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.
Conclusion
This case presents how to treat periimplantitis with i Brushing and additional laser & tetracycline treatment.
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