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CBCT scans images showing the large concave bone resorption due to peri-implant diseases involving implant-supported rehabilitation of 2.5 and 2.6.
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After an appropriate planning through tridimensional imaging from CBCT scans (Figure 1), a surgical approach with GBR of 2.5 together with the extraction of 2.4 and 2.6 (that was considered hopeless due to massive bone resorption and active infection) was decided.
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(a) Surgical site after extraction of 2.6 implant and 2.4 tooth contextually to accurately remove granulation and infected tissue. An intact portion of Schneiderian membrane is visible in the 2.6 implant site. (b) Surgical site showing the GBR technique used. A xenogeneic scaffold covered by a resorbable membrane was positioned circumferentially around the 2.5 implant generating a "regeneration chamber."
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One was placed in order to isolate the communication with the preserved Schneiderian membrane due to the extraction of 2.6 implant and the other to cover the graft (Figure 2).
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CBCT scans images after six months from surgical intervention showing a substantial stability of bone graft that allowed hypothesizing of the reosseointegration of the implant affected by peri-implantitis.
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After six months from surgical intervention a cone-beam computed tomography served to evaluate the stability of tridimensional bone graft over time (Figure 3).
Comparison between periapical and panoramic radiographs before and after 12 months from surgery.
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