Nonsurgical periodontal management of iatrogenic peri-implantitis: A clinical report

Dental implants have emerged as a first line of treatment to replace missing teeth for both the edentulous and partially dentate patients. The anticipated high degree of success is somewhat challenged by the onset of peri-implantitis. Peri-implant diseases are a cluster of "contemporary" oral infections in humans; they are characterized by the inflammatory destruction of the implant-supporting tissues, as a result of biofilm formation on the implant surface. It is still not clear how the roles of its etiologic agents work. A history of periodontitis, poor oral hygiene, and smoking are considered as risk factors for peri-implant diseases. Occasionally failing implants are associated with iatrogenic factors, that, only recently, have been acknowledged as direct cause of peri-implant complications, i.e.: non-parallel adjacent implants or the presence of a gap, between fixture and prosthetic components. The use both of traditional protocols of nonsurgical periodontal therapy and the diode laser seems to be an effective alternative treatment modality for peri-implantitis. By the application of laser-assisted non-surgical peri-implant therapy the periodontal pocket depth was reduced. Intraoral periapical radiographs, taken at 6 months and 1 year post nonsurgical treatment, seemed to provide evidence of some improvement of the bone level. The present article illustrates the nonsurgical management of one case, where failure to remove residual cement, from an implant-supported dental prosthesis, seemed to cause peri-implant inflammation.