Extreme peri - implantitis 1

Introduction Peri-implantitis leads to gradual peri-implant bone loss. Patients with implant supported restorations should be monitored in order to avoid extreme cases of peri-implantitis, followed by implant removal. The introduction of dental implants as a procedure to replace natural teeth lost due to dental caries, trauma or periodontal disease has been a major advance in the management of edentulous and partially edentulous individuals (Lindhe 2008). As nowadays the number of patients treated with dental implants continues to grow, the dentist and the patient must accept the challenges of maintaining these complex restorations. Peri-implant disease may only affect the peri-implant mucosa (peri-mucositis) or also involve supportive bone loss (peri-implantitis). Gradual peri-implant bone loss is determined by peri-implantitis. ”Periimplantitis” is defined as an inflammatory process affecting the soft and hard tissue around a functioning osseointegrated implant resulting in loss of supportive bone (Katsovilis 2008, Karoussis 2007). The prevention of biological implant complications relies on careful planning, a thorough examination to assess etiological factors, and a regular maintenance recall schedule. Patients must be thoroughly educated and retrained before deciding to commence implant therapy. The ability of the patient to understand financial, time, and maintenance obligations is crucial. There is a need to understand the importance of maintenance as it relates to long term implant success (McDermott 2003, Misch 2007). With early diagnosis, biological implant complications should be managed based on the severity of peri-implant disease, the amount of bone loss and the morphology of periimplant bony defects. Treatment modalities should be chosen based on the severity of peri-implantitis. For peri-implant defects with severe destruction of supportive bone, the removal of implants associated with guided bone regeneration is suggested (Silverstein 1998). The aim of this clinical case report is to present a severe case of peri-implantitis as a result of deficient maintenance associated with frequent loosening, absence of recall visits and poor oral hygiene.