Multiprotocol treatment modality in chronic peri-implantitis utilizing decontaminating, single phase bio-ceramic and autologous fibrin matrix

Abstract

Introduction: Peri-implant diseases are defined as pathological inflammatory reactions in the tissue surrounding osseointegrated implants. They are classified into two categories: mucositis—defined as peri-implant soft tissue inflammation and peri-implantitis—bone loss in the peri-implant region. Case Report: A clinical case of a 61-year-old woman with an implant in the 46 anatomical position presented with peri-implantitis after a 5-year follow-up. A probe depth of 5 mm and a bone defect length of 35% was observed. The Implacure Protocol was applied, with the main objective of eliminating the biofilm present on the exposed implant surface. There are multiple approaches to treat peri-implant diseases. While non-surgical treatment is essentially sufficient for mucositis control, the treatment in most cases of peri-implantitis should be surgery. Regenerative bone reconstruction promotes bone repair in the defect area and reduces bleeding during probing. To achieve that, autologous fibrin combined with Cerasorb M was used. Conclusion: The proposed approach in the presented clinical case involves the application of Implacure Protocol, whose combination of the physical decontamination technique, together with the use of chlorhexidine and orthophosphoric acid, added with the combination Piperacillin + Tazobactam together with hyaluronic acid, provided a base that allows to regenerate bone using platelet-rich fibrin with Cerasorb M and increase the implant survival time.