About 6 month ago otherwise healthy patient who underwent immediate placement/temporazation of implant in the central incisor area #8 with the surgical guide, just recently presented for final restoration appointment with fistula like structure next to the implant that would not bleed upon pressure application. New CT scan was ordered and shows that in the mesial area of the apical third of the implant has small area of fenestration. My intent would be to try to trace sinus track/fistula with GP, raise full thickness flap, currrete the site, treat the implant surface with rotobruches if exposed, irrigate the site and apply more bone and membrane. I was wondering if experts could advise me on what type of irrigation solution to use besides Chlorhexidine .05%, in addition to saline solution. What steps you would take to prepare and treat exposed implant treads, If you would recommend adding antibiotics to the graft itself, say for instance Arestin, or if you would recommend different type of topical antibiotics slurry prior to graft application. If so, could you please specify how you would prepare and treat exposed implant treads, what antibiotic slurry and at what concentrations do you use and how do you prepare your solutions. Thank you and your help in this matter is greatly appreciated.
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