Treatment of Refractory Apical Peri-Implantitis: A Case Report

Preoperative computerized tomography image of edentulous site #10.

Figure 2. Clinical appearance of sinus tract at the apical region of implant. Figure 3. Computerized tomography image of the periimplant apical lesion. Figure 4. Panoromic radiograph showed a radiolucency at the apical portion of the implant.

Figure 5. Granulation tissue at the apex of the implant. Figure 6. Bone defect and exposed implant apex after the curettage of the lesion. Figure 7. Cortico-cancellous graft mixed with tertacycline powder. Figure 8. Collagen membrane covered the defect area.

Recurrent apical lesion extended to adjacent canine tooth.

Figure 10. Apex of the implant resected with diamond burs under sterile saline irrigation. Figure 11. Defect filled with graft + platelet-rich fibrin mixture. Figure 12. Shaped platelet-rich fibrin membrane placed over the collagen membrane. Figure 13. The clinical view, at the 6-month control appointment, showed no sign of infection. Figure 14. Postoperative periapical radiograph (sixth month). Figure 15. Panoromic radiograph (first year control appointment).