Sticky Bone for Periimplantitis

There are signs of periimplantitis at #30 eleven months postop (Fig.1 (* bone loss)).  The bony defect (Fig.2) will be filled with allograft mixed PRF liquid to form sticky bone (Fig.3,4), followed by PRF membrane (not shown) and a piece of 6-month membrane (Fig.5).  A hole is cut so that the 6-month membrane can slide down the abutment (Fig.2,5 A) to cover the bone graft around the implant (Fig.2,7 I).  Setting acrylic is applied around the abutment and neighboring teeth for further protection and holding (Fig.8).  The periimplantitis does not resolve nearly 7 months post graft.  The implant will be removed.  Prepare UF extra wide kit and try to insert 6.5 or 7.0 mm tap.  Also prepare sticky bone and Cytoplast for wound closure.  Implant removal involves surgical handpiece, 6.2/7 mm trephine bur, elevators, and implant driver.  The defect is large (Fig.9) with the low buccal crest (Fig.10) and bone graft with PRF ("sticky bone") is placed, covered by PRF and 6-months membrane (Fig.11).  The next implant will be placed with guide.  If oral hygiene is not ideal, choose a bone level implant.  The middle of the wound dehiscences slightly 8 days postop (Fig.12), accounting for mild loss of bone graft 1 year postop (Fig.14).  The keratinized gingiva is apparently wide 1 year postop (Fig.13).  There is mild loss of bone graft in the middle of the superficial area (Fig.14).  The buccal plate seems to regenerate 1 year postop (pandemic delay, Fig.15).

Return to Lower Molar Immediate Implant, Armaments Trajectory II GEM21S 修复  拔牙后 第二次种植
Xin Wei, DDS, PhD, MS 1st edition 05/20/2019, last revision 01/11/2021