Treatment of Peri-implantitis with Tongue-thrust by Cumulative Interceptive Supportive Therapy Protocol: A Case Report

Periimplantitis is an inflammatory condition with soft-tissue inflammation along with subsequent loss of supporting bone around an implant. The present case report portrays the complete diagnosis and treatment of a patient with a loose implant-supported prosthesis. A 23-year-old male patient reported with loosened prostheses with respect to teeth #11 and #21-23. On intra-oral and radiographic examination, the case revealed peri-implantitis with implants related to #21-23. The patient also had a tongue thrust habit, which exerted extra pressure on maxillary anterior implants, causing their loosening. First, nonsurgical treatment, i.e., debridement and disinfection of implants with titanium curettes, was rendered. Surgical treatment was done by CIST Protocol D with soft-tissue diode laser and Calcium phosphosilicate putty bone graft. A habit-breaking appliance, i.e., a tongue crib, was also provided to the patient. Three- and six-month clinical and radiographic follow-up views have portrayed successful reosseointegration with concerned teeth, resulting in full return of function and fulfilling the patient’s aesthetic demands too.