Etiology of Periimplantitis

A 42-year-old woman presented to clinic 11 years ago with history of extraction of the tooth #19 two months earlier (Fig.1).  Two months later, a 5x8 mm Bicon implant was placed (Fig.2).  Integrated Abutment Crown was delivered 2 years later (Fig.3) with persistent radiolucency in the mesial socket.  The tooth #18 was extracted with socket preservation 7 years ago.  Recently she returned with chief complaint of chewing pain in the lower left for a while.  The buccal gingiva of #19 is erythematous, edematous and tender (Fig.4).  There are healing abutment at #29 and implant crown at #30. 

Periimplantitis at #19 is most likely due to buccodistal placement.  When it is removed (Clindamycin), a smaller IBS or SM implant will be placed immediately and mesiolingually (Fig.3).  For better wound protection with periodontal dressing or provisional, an implant will be placed at #18 at the same appointment.  Draw blood for PRF if the vein is large enough.  Surgical stents have been in cold sterilant.

Return to Lower Molar Immediate Implant, Prevent Molar Periimplantitis (Protocols, Table), Course 1 2 Fig.1 Remedy

Xin Wei, DDS, PhD, MS 1st edition 06/16/2017, last revision 06/26/2020