Three-year follow-up of a peri-implantitis case managed by titanium brush and tetracycline slurry for surface decontamination with guided bone regeneration

Peri-implantitis is one of the frequent complications associated with dental implants. Although several protocols have been given by different authors, there is no unified protocol for the management of peri-implantitis. A male patient aged 74 years reported to the department of implantology with a chief complaint of pain and swelling around the implants in regions 36 and 37. Probing depths ranging from 4 to 7 mm (Williams probe) were noted in respect to 36 and 37. Initial management was done nonsurgically by antibiotics and oral prophylaxis. Deep pockets and bleeding on probing persisted on re-evaluation. Surgical management involved elevation of a full-thickness mucoperiosteal flap, followed by thorough soft-tissue curettage using plastic curettes. The implant surface was detoxified with a tetracycline–saline slurry in conjunction with a titanium brush. Xenograft particulates were used to restore the osseous defect. Postoperative healing was uneventful, and probing depths were within the normal limits. Bleeding on probing was noted below 10%. Significant bone fill was also evident. This case report reveals successful management of peri-implantitis using regenerative procedures.