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Dr. H. asks:
I treatment planned a patient for an implant, abutment and PFM in #30 site [mandibular right first molar; 46]. The site did not have an adequate zone of attached gingival and had significant pull from buccal frena. The patient returned one year after implant installation and 6 months after PFM insertion. The patient presents with red and inflamed gingival and mucosa around the implant. Two threads are exposed. When she smiles, the frena pull causes some discomfort. My plan is to remove the crown and abutment, do a frenectomy, do a bone graft and soft tissue graft with Alloderm [LifeCell]. What would you recommend that I use to disinfect the implant threads? What bone graft material should I use? Any recommendations for salvaging this case?