Reconstruction of peri-implant-related intrabony defect

BioBrief - Peri-Implantitis

The Situation

Adult patient, a non-smoker and without relevant systemic history, visited the clinic reporting peri-implantitis symptoms, including peri-implant tissue inflammation and bleeding while brushing around implants in the upper jaw. A periapical X-ray revealed peri-implant bone loss, while clinical examination showed bleeding and suppuration on probing and a peri-implant pocket depth greater than 5 mm. Additionally, cone beam computed tomography (CBCT) was used to assess the presence of an intrabony defect configuration.

The Approach

The screw-retained supraconstruction was removed, and a full-thickness flap was raised. 

Surgical Procedure

Granulation tissue was debrided using manual curettes, and implant surface decontamination was performed with a powered titanium brush. 

Bone and Membrane Application

The intrabony defect and buccal bone wall were reconstructed using Geistlich Bio-Oss® Collagen, which was then covered with a Geistlich Bio-Gide® collagen membrane, adapted to the defect configuration. 

Fixation and Stabilization

An implant healing abutment and miniscrews were used to fix the membrane securely.

The Outcome

After one year of follow-up, successful results were observed based on both clinical outcomes and radiographic bone fill. The combination of Geistlich Bio-Oss® Collagen and Geistlich Bio-Gide® membrane effectively reconstructed the peri-implant-related intrabony defect and buccal wall, improving both volume and soft tissue contour.

Keys to Success

• Flap design
• Implant surface decontamination
• Adaptation of the bone graft
• Membrane fixation and stability
• Primary wound closure without tension
• Peri-implant supportive therapy