A Case Report of a 2-Year Follow-Up of Minimally Invasive Surgery in Peri-Implantitis: Peri-Implant Excisional Procedure and Access Surgery
This case report describes the treatment of peri-implantitis lesions through a minimally invasive surgical procedure using a peri-implant excisional procedure and access surgery (PEAS). The prosthesis was disconnected, and the peri-implant granulation tissue removed after a peri-implant circular incision. Chemical debridement with hydrogen peroxide on a cotton ball and then mechanical debridement with a rotary round titanium brush and tufted brush with titanium bristles were conducted. The surgical intervention was effective in arresting the peri-implantitis. No further radiographic bone loss was observed over the 2-year follow-up period. This technique effectively cleans the contaminated implant surface, minimizes surgical morbidity, and allows for prosthesis delivery on the day of surgery. However, further studies with a larger sample size are needed to identify the reliability and validity of this novel technique.
Figure 1. Clinical photograph before nonsurgical treatment. Inflammation signs including swelling, pus, and redness were observed. Figure 2. Radiographic photograph showing a crater-like peri-implant bone loss.
Figure 3. Clinical photograph before surgery. Figure 4. Pus discharge after local anesthesia. Figure 5. Prosthesis removal. Note the plaque accumulation around the prosthesis. Figure 6. Occlusal view after prosthesis removal. Figure 7. Peri-implant excisional procedure and access surgery (PEAS) was performed. Figure 8. The prosthesis was reconnected after the surgery.
Figure 9. Clinical photograph 2 year after the surgery. Note the marginal mucosal recession at the buccal site. Figure 10. Radiographic photograph 2 year after the surgery. Note that the crater-like shape bone loss has changed to a horizontal bone loss pattern and the bottom of the defect has shifted a little upwards.
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