Therapy for Peri-Implantitis: Significant Radiographic Bone Fill After Keratinized Mucosa Augmentation Surgery With Supportive Implant Therapy: A Novel Approach

(a) Demonstration of the definitions of the upper bone contour line (UBL) and deepest bone resorption line (DBL) in a patient with peri-implantitis (ITI Bonefit, length 12 mm) before surgical therapy. (b) Radiographically, the UBL values were 2.5 mm mesially and distally, while the DBL values were 7 mm mesially and 6.5 mm distally.

Figure 2. Patient No. 1: female, age 66 years (at the time of keratinized mucosa [KM] surgery). KM augmentation surgery: free gingival graft; implant system: AstraTech TX (L, 8 mm; D, 4 mm); inserted September 2012; implant position: 036; affected region: distal; observation period: 1.17 years.

Figure 3. Patient No. 2: female, age 44 years (at the time of KM surgery). KM augmentation surgery: free gingival graft; implant system: Ankylos (L, 11 mm; D, 3.5 mm and L, 8 mm; D, 5.5 mm); inserted April 2012; implant position: 035 and 037; affected regions: 035 distal and 037 mesial; observation period: 3.08 years.

Figure 4. Patient No. 3: male, age 67 years (at the time of KM surgery). KM augmentation surgery: partially epithelialized connective tissue graft; implant system: Ankylos (L, 11 mm; D, 4.5 mm); inserted June 2003; implant position: 045; affected regions: mesial + distal; observation period: 5.01 years.

Figure 5. Patient No. 4: female, age 66 years (at the time of keratinized mucosa [KM] surgery). KM augmentation surgery: free gingival graft [FGG]; implant system: ITI Bonefit (L, 12 mm; D, 4.1 mm); inserted October 1991; implant position: 036; affected regions: mesial + distal; observation period: 18.41 years.

Figure 6. Patient No. 4. Implants 36 and 37 before KM augmentation surgery via FGG (a) and a 5-year control (b).