Peri-implant complication Diagnosis
50yo Male non-smoker patient with an implant-supported anterior FPD presents complaining of "dull" pain associated with #11 implant that is the distal abutment for the implant-supported FPD and a "bump" in the area of the implant that is sore during brushing. Upon probing, probing depths were 1-3mm around the implants with no bleeding on probing. As part of the clinical exam the restoration was removed to access the site and a sinus tract stoma was found ~4mm below the mucosal margin. Upon palpation there was serous exudate coming out of the sinus tract. Tough diagnostic case. Dental history included placement of the implants several years ago to replace a failing tooth-borne bridge. The #11 area underwent ridge preservation followed by implant placement and contour augmentation. Ideas on possible diagnosis and diagnostic workflow?
Case treated by Drs. Chiu & Kotsakis, Seattle WA