Management of dental implants with significant bone loss due to peri-implantitis requires a carefully designed and staged treatment plan. This patient came to us for evaluation of his existing lower dental implant which had gradually lost its bone support with chronic pain and infection (Peri-implantitis)
The first step was atruamtic removal of the implant using reverse torque explantation technique. With this approach, the implant was removed without any cutting of surrounding bone. Next, the site was cleaned thoroughly. The gum tissue was noted to be relatively thick and healthy. Hence an immediate bone grafting was performed using guided bone regeneration technique to restore horizontal and vertical bone deficiencies.
The site was allowed to heal for 6 months. The Cone Beam CT Scan demonstrated total restoration of the missing bone. Next, digital diagnostics were obtained (CBCT and optical scan) and computer-assisted planning to optimize positioning of the new dental implant. A surgical guide was printed based on this work up and used during surgery for precise placement.
The dental implant was placed using the surgical guide. After a 4-month healing period, the implant was uncovered and then restored with a customized abutment and crown.
The keys to achieving success in this patient:
- Atraumatic explantation (implant removal)
- Proper bone reconstruction using guided bone regeneration techniques
- Digital diagnostics and planning for proper implant placement
- Precise placement of dental implant using a guided approach with a surgical guide