BACKGROUND: Peri-implantitis poses a significant challenge to implant longevity, leading to progressive bone loss and potential implant failure. While reconstructive surgery has been proven effective in regenerating peri-implant tissues, the long-term stability of the regenerated tissues and the impact of supportive peri-implant care (SPIC) on bone levels remains underexplored. This case study presents a 10-year follow-up of a patient treated with reconstructive surgery for peri-implantitis and enrolled in a structured maintenance program. METHODS: A 68-year-old male with a failing implant in the mandibular right first molar was treated using a reconstructive approach involving surface decontamination, particulate bone grafts, and an acellular dermal matrix as a barrier. Three re-entry procedures were performed over a 10-year period: at 9 months for the second stage of the two-step GBR procedure and at 8 and 10 years for implant placement to replace fractured teeth. These interventions allowed for direct clinical and radiographic assessment of bone-level changes. RESULTS: At 9 months, bone regeneration was observed with minor residual dehiscences. After 8 years, bone remodeling and crestal bone gain on the lingual aspect were noted in the absence of further surgical interventions. At 10 years, radiographic evaluations confirmed minimal changes in marginal bone levels. CONCLUSIONS: The presented two-stage regenerative approach successfully restored peri-implant health and function over time while minimizing the patient's financial burden. The three re-entry procedures provided direct clinical evidence of bone regeneration and demonstrated the positive impact of effective maintenance therapy on marginal bone levels and their long-term stability. KEY POINTS: The described regenerative treatment for peri-implantitis may ensure long-term satisfactory outcomes. Supportive peri-implant care (SPIC) is effective in preventing disease recurrence and may improve crestal bone levels over time. PLAIN LANGUAGE SUMMARY: This study presents the case of a 68-year-old patient with a failing dental implant due to peri-implantitis. The implant was treated by thoroughly cleaning its surface, placing bone grafts, and using a protective membrane to regenerate bone around the fixture and obtain disease resolution. The patient returned for three follow-up surgeries over 10 years, providing a unique opportunity to directly examine bone stability around the implant. Direct observations revealed that the bone graft healed well within the first 9 months, and the regenerated peri-implant bone remained stable with minimal changes for a decade. Regular check-ups and cleanings also helped prevent disease recurrence and further bone loss. By saving the existing implant, the patient avoided the extra expenses of removing and replacing it. Overall, these results suggest that a regenerative surgical approach, combined with structured maintenance care, can help obtain disease resolution and maintain stable long-term outcomes. This can improve comfort and function while reducing costs for patients.
Parma‐Benfenati et al. (Wed,) studied this question.