Preoperative observation
8mm of vertical bone loss was found on #45.

The implant was exposed with flap elevation and severe peri-implant bone loss was found.

A R Brush was used for mechanical cleansing of circumferential defect at 800rpm.

Noncircumferential defect was cleaned with an i Brush for 3 minutes each thread. It was used at 300 to 500rpm.

New rough surface has been created.

Bone material was applied to the defect.

The wound area was sutured.

Postoperative radiographic view verifies crestal level of peri-implant bone.
Conclusion
This case shows how to treat periimplantitis and create new rough surface using R Brush and i Brush. The defect caused by periimplantitis was filled with bone materials, and the final result of postoperative radiographic view verified crestal level of peri-implant bone.
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