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Keywords
Abscess, early peri-implantitis, implants, molecular biology, regeneration, surface etching
Abstract
Early peri-implantitis is one of the major causes of implant surgery failure. Caused by various factors such as pathogenic contamination, this condition needs a specific and professional intervention to re-stabilize the implant and to recreate osseointegration in the defected site. This article describes a treatment protocol that restores the bone-implant contact and renders the implant reliable and functional at the long term. In the aim of treating a peri-implantitis state and saving the implant, we opted for a simple protocol that treats the implant surface and stimulates the bone regeneration and bone-implant osseointegration. 1-year after the application of hydrogen peroxide 15% and citric acid combined with bone graftand resorbable membrane, the ex-defected implant was loaded after a neo-osseointegration formation all around the implant. 2 years later, the implant is still functional, and the peri-implant tissues show a healthy state. In conclusion, the good diagnosis and the fast intervention using implant surface etching and regenerative intervention were the key to success in this case. This case study encourages the use of the combined procedure of bone and membrane to stabilize the graftinto the bone crater, which is crucial for the formation of a neo-alveolar bone that surrounds the exposure surface of the defected implant.
Introduction
Inflammation due to oral bacteria could alter softand hard tissues around dental implant. If this degradation remains untreated, a progressive loss of supporting tissue and supportive bone will occur. This inflammation is called peri-implantitis.[1]
The irreversible changes in the crestal bone levels coupled to bleeding on probing, with or without pockets presence, are the most characteristic criteria of the peri-implantitis. In addition, peri-implantitis lesion suppuration could appear.[2]
Some of the risk factors of peri-implant diseases are poor oral hygiene, smoking, and history of periodontitis.[3] Nevertheless, early failure of dental implant is the most problematic incident during the healing procedure after the implant installing. Several factors of early implant failure are the low primary stability leading to minimal or non-osseointegration, the contamination of implant material and/or surgical site by pathogenic bacteria. In a recent study, author presents that patients who received pre-operative antibiotics showed fewer early implant failures.[4] Early failure rate of 0.6% is recorded in a study done by...