Surgical treatment of peri-implantitis via multiple decontamination procedures and a regenerative protocol: a case report with 6-year follow-up.

Peri-implantitis is an inflammatory disease around dental implants that induces progressive bone resorption. Several procedures for decontaminating the implant surface and promoting bone growth have been established to treat this condition. The purpose of the present case report was to describe the decontamination method used to achieve peri-implant health in a 60-year-old man who had a single implant that had been in function in the mandibular left molar region for 10 years. The implant, in the region of the first molar, was osseointegrated and showed radiographic bone loss associated with a probing depth of 8 mm and bleeding on probing. The diagnosis was peri-implantitis, and a surgical treatment approach was selected to enable decontamination of the area with a combination of mechanical debridement, tetracycline hydrochloride (500 mg/mL), and photodynamic therapy. After the decontamination process, a sodium bicarbonate spray device was used, and a guided bone regeneration protocol with a xenogeneic graft and collagen membrane was performed to reestablish the peri-implant bone height. A connective tissue graft was placed to obtain a better biological seal and increase the peri-implant keratinized mucosa. Follow-up examinations performed 30 days, 5 months, 3 years, and 6 years after the surgical procedure revealed new bone formation and progressively reduced probing depths. The successful outcome in this case suggests that combining different decontamination procedures and a bone regeneration protocol could be an effective approach to inducing bone formation around dental implants in patients with peri-implantitis.