Periimplatitis complex case
One year ago I asked what would you do to treat this patient. Now, it´s finished so I can show my solution to the case. The problem was two upper canines, implant screwed with extensive PERIIMPLANTITIS. If you see CBCT, you can see a huge bone destruction. What to do?
Also there are gums retractions on first bicuspids and laterals on both sides.
My idea was: not to treat the defect, and try to regenerate in order to insert another implant. I will change neighborhood: replace cuspids by bridges.
Before: ORTHO extrusion, to level gingiva margins, endo all abutments. Explantation WITHOUT flap to do IDR (immediate dentoalveolar reconstruction) Dr. De la Rosa technique, plus CTG. I´ve done another round of CTG later to add more volume. Zirconia bridge to add a nice contour and after 15 months was finalized last week. Patient is happy with the overall improvement. My worry was: is another solution, more easy to enhance and recover all the bone lost, the gingiva retraction and replacing the cuspids? Could not imagine. Thoughts?