CAN WE TREAT PERI-IMPLANTITIS? A CASE REPORT with 1 YEAR FOLLOW UP

Objectives: Peri-implantitis was defined as an inflammatory process around an osseointegrated implant in function, resulting in loss of supporting bone. Several approaches have been proposed to treat peri-implantitis, including mechanical debridement, antimicrobial therapy and resective or regenerative surgical therapy. This case report highlights that peri-implant treatment can be achieved succesfully via nonsurgical therapy.
Methods: Fifty-seven years old systemically healthy non-smoker male was referred to the Department of Periodontology, Abant Izzet Baysal University from a special clinic with complaint of pain, bleeding of gums, supuration around implants and bad breath. Clinical and radiological examination revealed as peri-implantitis in mandibular anterior region (probing pocket depht (PPD) >7 mm with supuration and bleeding on probing, marginal bone loss > 1/3 implant length) for each of four implants and gingival overgrowth around maxillar implants. While removing the prosthetic abutments, one implant was lost. Peri-implant therapy included debridement of implant surfaces using titanium curettes combined with systemic antibiotics and chlorhexidine. Gingival conturing was performed using Diode laser before prosthetic rehabilitation. Oral hygiene instructions were given to the patient and peri-implant clinical parameters were recorded at 1^sth, 3^th, 6^th and 12^th months. Four months after healing of peri-implant tissues prosthetic rehabilitation was completed.
Results: There was no bleeding on probing and supuration. Radiological bone fill around implants were seen and PPD was 4 mm. During the follow periods, these results were maintained and patient had no complaints about the prosthetic rehability.
Conclusions: Maintaining a healthy peri-implant tissue is much more difficult than placing an implant. This case report indicates that non-surgical approach with systemic antibiotics and chlorhexidine oral rinses are highly effective for treatment of peri-implantitis. There should be kept in mind that proper prosthetic rehabilitation and supportive periodontal treatment including oral hygiene motivation and regular dental visits are essential for maintaining healthy peri-implant tissues.