How to prevent iatrogenic periimplantitis? A clinical case report

Abstract

Relevance. Iatrogenic factors are among the significant causes of chronic peri-implantitis, the incidence of which reaches 16-28% according to various data. This article is a clinical case report which describes an approach to the treatment of iatrogenic peri-implantitis associated with a non-absorbable buried suture. Patient Sh., born in 1960, physically healthy, complained of gum bleeding in the region of implant 3.6.

Diagnosis. Сhronic peri-implantitis in region 3.6. The treatment was carried out in two stages. During the first (revision) stage, the buried suture of a non-absorbable 2-0 monofilament thread with uncut ends and a loose titanium pin were removed; during the second (reconstructive) stage, a free gingival graft (FGG) was used.

Results. The inflammation in the area of implant 3.6 resolved, the soft tissue condition was stable in the immediate and delayed postoperative period. In 3 months after the beginning of the treatment, the cervical bone defect repair was confirmed by the control X-ray.

Conclusion. The use of non-absorbable suture material for buried sutures in dental implantation and oral reconstructive surgical interventions is classified as iatrogenesis and is defined as a “medical treatment error”. In the present clinical case, it became the cause of the development of an implant site-specific inflammatory destructive complication. The reduction of chronic peri-implantitis incidence, taking into account its prevalence and problematic nature, requires further research and optimization of the protocols of dental implant treatment.