Long Term Of Implant Restoration In Stage Iv Periodontitis

This case presents a 10-year follow-up of a patient with generalized stage IV, grade C periodontitis, successfully treated with periodontal and implant therapy, emphasizing the value of a multidisciplinary approach. A 48-year-old male presented in January 2012 with complaints of progressively worsening tooth mobility in the posterior region over the past year, accompanied by gingival bleeding and recurrent swelling. He reported long-standing chewing difficulty due to missing molars lost 5–6 years earlier because of increased mobility. Oral examination revealed poor hygiene, severe gingival inflammation, and widespread recession. Full-mouth probing showed 100% BOP, 60% of sites ≥4 mm, and 27.3% ≥7 mm. Severe bone loss was seen on radiographs. Treatment included oral hygiene instruction, SRP, selective extractions, and GTR with bone grafting at sites 35 and 37. Implant-supported prostheses were chosen. Lateral sinus lifts were performed before placing implants at 15, 16, 24, 25, 26 (maxilla) and 36, 45, 46 (mandible). Prostheses were delivered in 2013–2014. Regular maintenance showed stable outcomes, except implant 24, which showed marginal bone loss, likely due to crown design and occlusal overload. Long-term success in advanced periodontitis depends on careful planning and maintenance. The bone loss of implant 24 highlights biomechanical considerations in high-risk sites. Even in stage IV periodontitis, long-term implant success is possible with meticulous planning and care. Attention to surgical technique and occlusion is essential for site-specific stability.