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Perio-Implantitis Treatment
Posted on 10.12.2012 10:11 AM
By Stefano Petti
In Failures
One case of perio-implantitis in mandible, with buccal bone loss and thread exposure, also mucositis were present, and patient referred a little local pain.
After the elimination of granular tissue, the surface's decontamination was performed using sequentially chlorhexidine gel and tetracycline antibiotic past.
This represents a case with a favourable prognosis because the body of the implant is located inside the bone wall, and the two interproximal peaks are preserved.
image of buccal loss
filling defect with particulate bovine bone after surface's decontamination 3' 0,2% Chlorhexidine gel and 1' Tetracicline paste
covering with resorbable(collagen) membrane
control after 6 months
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7 Comments
ezequiel poviña says on 10.12.2012 10:54 AM
No usa PRP Plasma rico en plaquetas para tal caso? Y existe oseointegracion del nuevo hueso sobre las expiras expuestas? gracias
Stefano Petti says on 10.12.2012 11:20 AM
Yes I was going to specify that I use every time to mix the graft with the platelet concentrate, and yes as you can note the new bone is grown over exposed thread...
ali momen says on 10.12.2012 03:38 PM
thank you dr petti. i saw this case on your site.perfect treatment but why reentry? i prefer bone sounding that is less invasive than reentry. periosteum is a SLEEPING GIANT that with flap reflection wake up.
Ali
Stefano Petti says on 10.13.2012 01:32 AM
Tanks Dr.Ali
Is not dangerous to reflect a flap if you respect local vascularization.
Maurice Salama says on 10.12.2012 10:43 PM
Stefano; Thanks for posting. Nice result and I appreciate the re-entry photo. How do you disinfect the implant surface?
Any laser use? Surface treatment? thanks
Dr. Salama
Stefano Petti says on 10.13.2012 01:02 AM
Thanks Dr. Salama,
No laser, no Ti brush , only chemical treatment as described upper.
Actually I have modified the protocol using 0,5% chorhexidine gel for 5 min and tetracycline antibiotic paste for 3 min that I leave to act also on the bone surface around the implant.
Further I recommend oral antibiotic treatment consisting of amoxycilline associated with metronidazole.
It is described that tetracycline stimulates a fibroblasts growth in the affected area.
http://www.chsjournal.org/archive/vol-36-no3-2010/updates/periimplantitis-aetiology-diagnosis-treatment-a-review-from-the-literature
Paco artasanchez says on 10.30.2012 06:36 AM
Es un caso interesante y muy habitual. Obtener exito a largo plazo es muy dificil yo diria que imposible... EL tratamnineto es desinfectar pero a la fecha lo que mejor resultado da es el bicarbonato y el H2O2. Despues se pone biomateriales y es muy interesante el uso de PRGF endored del Dr. Anitua.
Si esto no funciona lo mejor es quitar el ipante regeneracion y volver a empezar con implantes de reduccion de plataforma conexion intyerna y pilares biologicos..
Cuelga las fotos al año y a los dos años.
Un saludo
PAco Mantecon