Treatment of peri-implant defect with modified sandwich bone augmentation. Case report and follow-up

This report describes correction of an osseous defect around a dental implant with a modification of a sandwich bone augmentation (SBA) technique. It gives detailed information about preparation and application of the autologous platelet rich plasma (PRP). A 58-year-old female patient complaining of halitosis, function loss and discharging pus at her right lateral dental implant was referred to the Department of Periodontology at Hacettepe University. An implant had been placed two years prior; a porcelain restoration was completed a year after surgery. An advanced peri-implant problem was noticed, and an SBA technique modified with PRP and tri-calcium phosphate application was subsequently performed. Clinical parameters and radiological evaluations were performed at baseline, 3, 6 and 12 months following the procedure. A 2 mm attachment gain, 3 mm reduction in probing depth and 2 mm alveolar bone gain were achieved a year after the surgical procedure. SBA technique modified with PRP application resulted in clinical benefits. Early wound healing was achieved without any postoperative bleeding. Peri-implantitis defect treated with SBA technique with autologous PRP and tri-calcium phosphate application appears to improve early wound healing and may influence acceptable regeneration.