Treat peri-implantitis: Most effective way without using a laser?

I have a case of peri-implantitis with 4mm bone loss, suppuration and bleeding on probing. The implant was placed about 4 years ago. I plan to do open flap surgery and GBR, but I do not have a laser. What do you recommend as the most effective way to disinfect the implant surface without using a laser?

4 thoughts on: Treat peri-implantitis: Most effective way without using a laser?

  1. Bülent Zeytinoğlu says:

    ı think the case is hopeles if ı were you under AB coverage ı would explant debriment the cavity and leave it for spontaneous healing . Good Luck

  2. Greg Kammeyer, DDS, MS says:

    Dr Froum and Rosen have 2 papers, case series on this and the largest number of patients treated that I am aware of in the Int. J of Perio and Rest Dent. Following his protocol I use an air abrasion unit, being careful not to blow air sublingually in the mand post. 3 rounds of that with irrigation after each with Citric Acid, CHX and parental clindamycin (abrade, saline irrigation, chemically treat x 3) after each irrigation. Then he routinely uses GBR with PDGF or Emdogain (I prefer PDGF), a Connective tissue graft and primary closure. His results show significant pocket reduction and the shape and size of the defect determines the amount of bone regenerated (2-3-4 walled defect). He also includes multiple visits PO for oral hygiene including dying the bacteria with the red disclosing tablets. Many do implantoplasty to get a clean implant surface. I don’t see that as very practical to get all the contaminated surfaces clean. Regardless Froum’s protocol is time consuming (until you do a few) and expensive to the patient so being sure he/she get the pros and cons of attempting to save the implant. Look up his papers on this before treating the patient. The second paper has over 100 cases. Good Luck.

  3. Bill Woods says:

    I’m glad to see clindamycin as a part of this. I’ve been using this even with my initial bone grafts for years. It was anecdotal for me at the onset but makes much sense.

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