Surgical therapy of periimplantitis is the topic of the sixth and seventh part of the lecture series by Professor Dr. Stefan Renvert, University of Kristianstad/Sweden, held on the EDA Early Dental Workshop. In this sixth part he focusses on the selection of the procedure dependent on defect type and treatment aim. While a periimplant mucositis can be treated minimal-invasively by oral hygienic means indeed, a periimplantitis has to be treated surgically.
In best case the result is the regeneration of the bone defect and at last even a re-osseointegration of the affected implants. Dependent on the number of affected walls of the bone defect you choose a regenerative or a resective approach. The latter is to eliminate periimplant pockets and to optimize the periimplant hygienic ability. The regeneration aims to achieve a restitutio ad integrum. Local flap techniques create an access to the contaminated implant surfaces.
Subsequently the surfaces are cleaned manually without destroying the micro architecture. To achieve a regain of bone substance lost bone substitute materials are used, possibly combined with membranes. A free mucosal graft or subepithelial conjunctive tissue can be used additionally to create keratinized gingiva around the implants.