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Charlie Maran

Edinburgh, United Kingdom

Clinical case description:

Surgical management of peri-implantitis: A case report

C. M. D. Maran, M. J. Brennand Roper, A. Dutta.

 

 

This case describes the treatment of a patient who was initially provided with a single implant retained prosthesis and who subsequently went on to develop peri-implantitis. This was initially treated non-surgically but failure to achieve peri-implant tissue health prompted surgical intervention. The patient presented in this case was a 50 year old male who had lost tooth 21 due to trauma and was provided with implant therapy in 2007. The implant was restored with a cement retained porcelain bonded crown and composite resin was used to close the diastema. The patient was returned to his General Dental Practitioner for maintenance and routine dental care following a six month post-restoration follow up. In 2010, the patient was re-referred with a diagnosis of peri-implantitis associated with tooth 21. Pocket probing depths of 10mm with suppuration and bone loss were recorded. The patient underwent a non-surgical disinfection stage via ultrasonic debridement and subsequently consented to a surgical approach in an attempt to resolve the peri-implant inflammation.

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<p>Pocket probing depths of 10mm with suppuration and bone loss were recorded.</p>

Pocket probing depths of 10mm with suppuration and bone loss were recorded.

<p>The defect was accessed via a three-sided full thickness muco-periosteal flap. The exposed threads were readily obvious to a depth of 3.5mm from the polished collar. The crown was dislodged upon raising the flap. An implantoplasty was performed and granul</p>

The defect was accessed via a three-sided full thickness muco-periosteal flap. The exposed threads were readily obvious to a depth of 3.5mm from the polished collar. The crown was dislodged upon raising the flap. An implantoplasty was performed and granul

<p>The wound was closed with 4-0 absorbable polygalactin sutures and the patient was given oral hygiene advice that included chlorhexidine gluconate mouthwash twice daily for 2 weeks.</p>

The wound was closed with 4-0 absorbable polygalactin sutures and the patient was given oral hygiene advice that included chlorhexidine gluconate mouthwash twice daily for 2 weeks.

<p>In 2014 the pocket probing depth had reduced to 3mm at the mid facial aspect with no sign of suppuration or bleeding on probing. The maintenance program continues to provide supportive non-surgical therapy and reviews at six monthly intervals.</p>

In 2014 the pocket probing depth had reduced to 3mm at the mid facial aspect with no sign of suppuration or bleeding on probing. The maintenance program continues to provide supportive non-surgical therapy and reviews at six monthly intervals.

Pre-surgery


					<p>Pocket probing depths of 10mm with suppuration and bone loss were recorded.</p>

Surgery


					<p>The defect was accessed via a three-sided full thickness muco-periosteal flap. The exposed threads were readily obvious to a depth of 3.5mm from the polished collar. The crown was dislodged upon raising the flap. An implantoplasty was performed and granul</p>

Outcome


					<p>The wound was closed with 4-0 absorbable polygalactin sutures and the patient was given oral hygiene advice that included chlorhexidine gluconate mouthwash twice daily for 2 weeks.</p>

Follow-up after at least 6 months


					<p>In 2014 the pocket probing depth had reduced to 3mm at the mid facial aspect with no sign of suppuration or bleeding on probing. The maintenance program continues to provide supportive non-surgical therapy and reviews at six monthly intervals.</p>