I am pleased to share the sixth case in our biweekly clinical series. As in the previous session, today we present a case of peri-implantitis and its contemporary treatment strategies.

Peri-implantitis is diagnosed based on clinical signs of inflammation and/or suppuration, progressive loss of supporting bone, and increasing probing depths. Treatment focuses on bacterial decontamination of the implant surface, as well as surgical management of the residual anatomical defect.

This case began with the diagnosis of peri-implantitis at implants #3 and #4, which presented tissue necrosis, deep pocketing, and radiographic bone loss. The implant surface was compromised 10 mm in length, including a 4 mm infrabony component with regenerative potential, and a 6 mm suprabony component without biologic potential for bone regeneration. Following therapy, the previously inflamed and necrotic tissues appeared clinically healthier and more firmly adapted to the implant surface.

Treatment was followed by a gingival graft aimed at improving the tissue phenotype, increasing the thickness of attached gingiva, and expanding the width of keratinized tissue.

The referring doctor, the patient, and our team were very pleased with the outcome, which included an improvement in the implants’ prognosis from unfavorable to favorable.