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Non-Surgical Bone Regeneration around a Dental Implant

60 year old male patient presented with peri-implantitis around implant placed in 2010. The patient is a non-smoking diabetic with inconsistent blood sugar control. There is no history of periodontal disease on natural teeth and the extracted tooth was removed due to fracture. Periodontal flap surgery was performed and residual cement removed with a cancellous allograft and collagen membrane placed. After 6 months of healing, radiographs determined that there was insufficient bone fill and exudate upon palpating and probing persisted. The implant probed 6-8 mm in all sites. This patient was placed in my recall schedule to help maintain the implant, in ailing health and slow the progression of bone loss. At each recall, air flow therapy with glycine powder was performed through the whole mouth for biofilm management. The implant was irrigated for 3-5 minutes buccal and lingual with 10% iodine solution. After maintenance of the natural dentition, full mouth laser disinfection was performed with a Nd:Yag laser. Recall frequency was 3 months and after 2 visits, there was no longer any exudate present upon palpating the ridge or upon probing. By one year, the probing depths had decreased to no greater than 5 mm and there was radiographic evidence of bone regeneration. Patient's home care included use of a water flosser with an over the counter anti-microbial rinse at 100% strength in the water flosser ( Closys brand).

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one year later
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Non-Surgical Bone Regeneration around a Dental Implant

60 year old male patient presented with peri-implantitis around implant placed in 2010. The patient is a non-smoking diabetic with inconsistent blood sugar control. There is no history of periodontal disease on natural teeth and the extracted tooth was removed due to fracture. Periodontal flap surgery was performed and residual cement removed with a cancellous allograft and collagen membrane placed. After 6 months of healing, radiographs determined that there was insufficient bone fill and exudate upon palpating and probing persisted. The implant probed 6-8 mm in all sites. This patient was placed in my recall schedule to help maintain the implant, in ailing health and slow the progression of bone loss. At each recall, air flow therapy with glycine powder was performed through the whole mouth for biofilm management. The implant was irrigated for 3-5 minutes buccal and lingual with 10% iodine solution. After maintenance of the natural dentition, full mouth laser disinfection was performed with a Nd:Yag laser. Recall frequency was 3 months and after 2 visits, there was no longer any exudate present upon palpating the ridge or upon probing. By one year, the probing depths had decreased to no greater than 5 mm and there was radiographic evidence of bone regeneration. Patient's home care included use of a water flosser with an over the counter anti-microbial rinse at 100% strength in the water flosser ( Closys brand).

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