Journal of Oral Implantology June 2014 - (Page 299)

CASE REPORT A Two-Stage Surgical Approach to the Treatment of Severe Peri-Implant Defect: A 30-Month Clinical FollowUp Report Jong-Eun Kim, DDS, MSD1 Ha-Young Kim, DDS, MSD1 Jung-Bo Huh, DDS, MSD, PhD2 Jeong-Yol Lee, DDS, MSD, PhD1 Sang-Wan Shin, DDS, MSD, PhD1* With the advance of dental implant technology and the consequential increase in its success rate, the implant has become a highly predictable treatment method. Despite this, related complications are on the rise, with peri-implant mucositis and peri-implantitis being the most commonly observed. As in the case of conventional periodontitis, many patients experience peri-implant mucositis and peri-implantitis. In this case presentation, extensive bone loss occurred around the implant due to peri-implantitis, and the infection was first treated by applying chlorhexidine-soaked gauze and topical antibiotics. Then the guided bone regeneration procedure was performed using a bovine bone material and a collagen membrane, which resulted in the recovery of the lesion. With follow-ups of the healing process for 30 months, a successful outcome was observed that is reported herein. Key Words: implant, guided bone regeneration, peri-implantitis, infrabony defects, surface treatment INTRODUCTION I nterest in and studies on osseointegration between an implant and the bone, which Branemark triggered in the late 1960s,1 have been on the rise. The osseointegrated implant has become known as the clinically widely accepted and reliable treatment option for restoring the edentulous area. With the increase in the clinical use of implants, the incidence of related complications also increased, with peri-implant mucositis and periimplantitis being the most common. Peri-implant 1 Postgraduate School of Clinical Dentistry, Institute for Clinical Dental Research, Korea University Medical Center, Korea University, Seoul, South Korea. 2 Department of Prosthodontics, Institute of Translational Dental Sciences, School of Dentistry, Pusan National University, YangSan, South Korea. * Corresponding author, e-mail: swshin@korea.ac.kr DOI: 10.1563/AAID-JOI-D-12-00030 mucositis is a reversible inflammation of the soft tissue around an implant. Characteristic clinical findings of peri-implantitis are bleeding on probing (BOP) suppuration, and a probing pocket depth (PPD) of 4 mm or more. The characteristic radiographical findings include bone resorption.2 Inadequate treatment may result in total loss of osseointegration, and consequential loss of the implant.3 About 28%-56% of subjects treated with dental implants reportedly experience peri-implantitis. In 12%-43% of implant sites, peri-implantitis is known to occur.4 As with conventional periodontitis, many patients are experiencing peri-implantitis. The most significant risk factors of peri-implantitis are known to include poor oral hygiene, a history of periodontitis, and smoking. Uncontrolled diabetes and drinking alcohol are known to be slightly related to peri-implantitis.2 Other risk factors include occlusal overload,5 and iatrogenic factors such as excess cement, improper seating of the Journal of Oral Implantology 299

Table of Contents for the Digital Edition of Journal of Oral Implantology June 2014

Controlled Early Inflammation and Bone Healing—Potential New Treatments
Zygomatic Implants: The Impact of Zygoma Bone Support on Biomechanics
A Comparative Study on Microgap of Premade Abutments and Abutments Cast in Base Metal Alloys
Topical Simvastatin Improves the Pro-Angiogenic and Pro-Osteogenic Properties of Bioglass Putty in the Rat Calvaria Critical-Size Model
Assessment of the Correlation Between Insertion Torque and Resonance Frequency Analysis of Implants Placed in Bone Tissue of Different Densities
Benefits of Rehabilitation With Implants in Masticatory Function: Is Patient Perception of Change in Accordance With the Real Improvement?
A Method for Fabrication of Implant-Supported Fixed Partial Dentures
Safe Sinus Lift: Use of Acrylic Stone Trimmer to Avoid Sinus Lining Perforation
The Effects of Sinus Membrane Pathology on Bone Augmentation and Procedural Outcome Using Minimal Invasive Antral Membrane Balloon Elevation
Cellular Responses to Metal Ions Released From Implants
A Two-Stage Surgical Approach to the Treatment of Severe Peri-Implant Defect: A 30-Month Clinical Follow-Up Report
Eight-Year Follow-Up of a Fixed-Detachable Maxillary Prosthesis Utilizing an Attachment System: Clinical Protocol for Individuals With Skeletal Class III Malocclusions
Active Implant Peri-Apical Lesion: A Case Report Treated Via Guided Bone Regeneration With a 5-year Clinical and Radiographic Follow-up
Flapless Implant Placement: A Case Report
Active Implant Periapical Lesions Leading to Implant Failure: Two Case Reports
A Review of Platelet Derived Growth Factor Playing Pivotal Role in Bone Regeneration
LETTER TO THE EDITOR
REVIEW OF CURRENT LITERATURE

Journal of Oral Implantology June 2014