Use of an Autogenous Connective Tissue Graft to Treat Peri‐Implantitis With Gingival Recession Affecting an Implant Supporting an Overdenture

Abstract

Introduction: Bone loss associated with peri‐implantitis can result in exposure of the implant surface. A lack of keratinized mucosa has been associated with increased plaque accumulation, attachment loss, and mucosal recession. This case report describes the benefits of connective tissue (CT) grafting in the treatment of peri‐implantitis and gingival recession affecting an implant supporting an overdenture. To the best of the author's knowledge, there are few clinical case reports depicting this treatment for implants supporting overdentures. Case Presentation: A 75‐year‐old female was diagnosed with peri‐implantitis associated with an implant that supported a mandibular overdenture. The bone loss and gingival recession was on the facial aspect of the implant. The roughened threaded surface of the implant was exposed, and there was an absence of facial keratinized mucosa. Peri‐implant therapy included surgical access to debride the area and decontaminate the implant surface using a 3% hydrogen peroxide rinse. This site was then treated with CT grafting using an autogenous CT graft. At the completion of treatment, the implant site was found to be healthy with greatly improved implant coverage and an increased keratinized tissue width. Conclusion: The use of an autogenous CT graft can be an important part of treatment of peri‐implantitis when there is gingival recession and a lack of keratinized mucosa.

Soft tissue features of peri‐implant diseases and related treatment

“…165 No significant differences were observed among the three groups for clinical and radiographic outcomes, except for KM width that was greater at the implant sites treated with CTG, while the other groups exhibited loss of KM width compared to baseline. 165 The application of CTG in concomitance with open flap debridement and decontamination of the implant surface has also been advocated by Mahn, that in a case report, showed resolution of the peri-implantitis condition after 3 months, with complete coverage of the soft tissue dehiscence and a mean KM width gain of 2.5 mm, which was probably due to the collar of the CTG that was left intentionally exposed, 166 rather than the capacity of the graft to induce keratinization of the alveolar mucosa. 150 Bilaminar techniques for soft tissue augmentation have also been utilized during regenerative therapies or combined resective and regenerative treatments of peri-implantitis.…”