Diagnosis and classifying peri-implantitis to elect the appropriate treatment.

A Regenerative Approach to peri-implantitis

Dr. Hector I. Sarmiento · United States
 · July 21, 2023

BioBrief - Peri-implantitis

The Situation

A 55 year old man was referred to me by his general dentist. Upon initial clinical and radiographic findings, failing implant #9 showed signs of peri-implantitis that included BoP, Suppuration, 9+mm PD and radiographic bone loss affecting both the implant and the natural adjacent tooth. Patient stated that although his gums bleed, he does not have any pain. Gingival erythema was also found.


The Approach

The clinical goals were to eliminate the peri-implant infection, restore hard and soft-tissues and have long-term success. The technique utilized was a systematic regenerative approach to eliminate the underlying cause of the peri-implantitis infection and restore hard and soft-tissues to prior health.


The Outcome

My observation at the 1.5 year follow-up shows the elimination of peri-implantitis and complete peri-implant health was achieved showing a reduction in BOP, PD and most importantly soft tissue thickness stability. Radiographically, crestal bone shows no signs of progressive pathological loss and has maintained adequate volume.


Keys to Success

  • Diagnosis and classifying peri-implantitis elect the appropriate treatment.
  • Detoxification methods.
  • Hard-tissue enhancement with Geistlich Bio-Oss®.
  • Guided bone regeneration with Geistlich Bio-Gide®.
  • Soft-tissue enhancement with Geistlich Fibro-Gide®.


About the author

Dr. Hector I. Sarmiento | United States

Dr. Hector Sarmiento was awarded his D.M.D. degree by the University of Rochester. Heis uniquely trained in both maxillofacial surgery and periodontics. He is a professor in the maxillofacial surgery department of trauma and reconstructive unit at the Regional Hospital in Mexico and is an Assistant Clinical Professor in periodontics at the University of Pennsylvania. Along with his periodontal degree, he also received his masters in oral biology from the University of Pennsylvania. Dr. Sarmiento is an international and national lecturer and has published numerous articles in peer reviewed journals and textbooks. His research focus includes infected dental implants such as peri-implantitis, sinus complications as well as bone biology. Dr. Sarmiento maintains his private practice in the upper east side of Manhattan in NYC

Department of Periodontics and Implant Dentistry, University of Pennsylvania, Philadelphia, Private Practice, New York