Surgical management of peri-implantitis using prf an interdisciplinary approach

Background: Peri-implantitis is an irreversible disease of implant-surrounding hard and soft tissues and is accompanied with bone resorption. The presence of periodontitis or cigarette smoking increased the risk for peri-implantitis. A 23-year-old female patient visited Department of Periodontics, with the chief complaint of exposed implant surface with respect to left upper front tooth region. On eliciting personal history, the patient reported that, she got her front tooth extracted due to trauma 3 years back. After 6 months patient got her tooth replaced by an implant.
Intraorally gingiva was pale pink in color with patches of melanin pigmentation around the implant surface in the left upper central incisor region. Marginal gingiva was rolled out with loss of normal gingival scalloping. On palpation, gingiva was soft and oedematous in consistency. The probing elicited bleeding and a pocket depth of 6mm around the implant with the exposure of an implant abutment around 3mm.Radiographic examination showed the presence of horizontal bone loss on either side of the implant. Based on the patient's clinical features and radiographic evaluation, a diagnosis of peri-implantitis was made.
Treatment: The patient was treated initially by nonsurgical approach, mechanical debridement of the implant surface with plastic-curettes was carried out. After a week a mucoperiosteal flap was raised, sulcular incision was given from 11 to 23 along with vertical incision extending from mesial line angle of the 23. After thorough mechanical debridement, prepared PRF was incorporated into the defect area, flap was closed with continuous interlocking sutures and postoperative instructions were given. After 2 weeks of satisfactory healing, patient was referred to Department of Prosthodontics for the new prosthetic replacement.
Conclusion: Conventional surgical approach of managing peri-implantitis with the placement of PRF for periodontal soft and hard tissue augmentation was successful with uneventful healing.