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

    (0)
  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.

    (0)
  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.

    (0)

Leave a Comment:

Comment Guidelines: Be Yourself. Be Respectful. Add Value. For more details, read our comment guidelines. Though we require an email to comment, we will NEVER publish your email.
Required fields are marked *

Posted in Clinical Questions, Surgical.
Bookmark Treat peri-implantitis: Most effective way without using a laser?

Videos to Watch:

Titanium Mesh for Ridge Augmentation

The use of titanium mesh is a reliable method for ridge augmentation to provide adequate[...]

2 Comments

Watch Now!
Implant Grafting Techniques: Demineralized Sponge Strip and Tunneling

This video reviews several unique grafting and surgical techniques, including the use of demineralized cancellous[...]

Watch Now!
Mandibular Fixed Screw Retained Restoration

This video shows the use of a surgical guide for a mandibular fixed screw retained[...]

1 Comment

Watch Now!
Clinical Tip for Fixation of a Collagen Membrane

This video provides a clinical tip with regards to the fixation of a collagen membrane.[...]

Watch Now!
Lower Molar Extraction with Graft

Video showing lower left first molar extraction, followed by a socket graft, and then immediate[...]

3 Comments

Watch Now!
Maxillary Bone Reconstruction

This video demonstrations Maxillary Bone Reconstruction using Subnasal Floor Elevation and an Osteotome Closed Approach[...]

Watch Now!
Infection of Lower Premolar: Extract and Place Implant

In this video, the lower left 2nd premolar was extracted due to infection, and implants[...]

Watch Now!
Flapless Immediate Implant and Provisional

This video shows a technique showing using the patient's own tooth as a provisional at[...]

Watch Now!
Extraction and Immediate Implant with Luxator LX

Extraction of tooth #8, using Luxator LX, and then an immediate implant and provisional.[...]

3 Comments

Watch Now!
Dealing with the Implant Gap

This short video discusses how to best deal with the gap after immediate implant insertion[...]

1 Comment

Watch Now!
Lower Right Molar Extraction & Immediate Implant Placement Using i-PRF

In this video, the lower right second molar was extracted and grafted with i-PRF and[...]

13 Comments

Watch Now!
Maxillary Implantation with Treatment of Chronic Sinusitis

This video shows two cases where implants were placed following treatment of Sinusitis. [...]

3 Comments

Watch Now!