How to rescue a malpositioned implant with distal bone defect?

Reconstruction of peri-implant-related intrabony defect

Dr. Alberto Ortiz-Vigón · Spain
 · April 25, 2024

BioBrief - Peri-Implantitis

The Situation

Adult patient, non-smoker and without relevant systemic history, attendes to clinic refering peri-implant tissue inflammation and bleeding on brushing in her implants in the upper jaw. Peri-implant bone loss was observed in the periapical x-ray and bleeding and suppuration on probing and peri-implant pocket depth > 5 mm clinically. In addition, cone beam computerized tomography was used focused on assessing the presence of intrabony defect configuration.


The Approach

Screw-retained supraconstruction was removed. Full thickness flap was raised, debridement of granulation tissue was conducted with manual curettes and implant surface decontamination with powered titanium brush. The intrabony component and the buccal bone wall were reconstructed by means of Geistlich Bio-Oss® Collagen and covered by Geistlich Bio-Gide® collagen membrane according to defect configuration. Implant healing abutment and miniscrews were used to fix the membrane


The Outcome

After 1 year follow-up successful outcome can be observed taking into account clinical outcomes and radiographic bone fill. The therapeutic approach of combining Geistlich Bio-Oss® Collagen and Geistlich Bio-Gide® membrane is enable to reconstruct peri-implant-related intrabony defect and buccal wall improving the volume and soft-tissue contour or profile.


Keys to Success

  • Flap design
  • Implant surface decontamination
  • Adaptation of bone graft
  • Membrane fixation and stability
  • Primary wound closure without tension
  • Peri-implant supportive therapy

About the author

Dr. Alberto Ortiz-Vigón | Spain

Dental surgeon
Clinical director of Clínica Ortiz-Vigón PerioCentrum Bilbao