Implants · patient case question
How is established peri-implantitis with radiographic bone loss best managed?
Patient case: Inflammation around an established implant
Patient: Adult with an implant-supported restoration placed several years ago
Chief complaint: Bleeding and discomfort around the implant.
Background: Implant restored and functioning for several years.
Current findings: Bleeding on probing, deep peri-implant pocketing and radiographic bone loss around the fixture.
Show answer and explanation
Correct answer: B. Surgical debridement
- A. Chlorhexidine alone is adjunctive and cannot resolve established bone loss.
- B. Once there is established bone loss, non-surgical measures alone rarely achieve resolution, because the roughened implant surface cannot be adequately decontaminated through a pocket. SURGICAL access permits direct debridement, surface decontamination and, where the defect morphology allows, regenerative grafting.
- C. Non-surgical debridement is the correct treatment for PERI-IMPLANT MUCOSITIS — inflammation without bone loss — and is the reversible stage.
- D. Explantation is the last resort, for implants with advanced bone loss and mobility.
Note: The source note reads: surgical debridement, unless the option explicitly pairs scaling and root planing WITH chlorhexidine. Distinguish mucositis (no bone loss, reversible, non-surgical) from peri-implantitis (bone loss, usually surgical).