3-Year Follow-Up After Peri-Implantitis Treatment

This case report presents a peri-implantitis through combined non-surgical and surgical treatments, ideal soft and hard tissue restoration was achieved. The peri-implant soft and hard tissues have remained stable during 3 years of postoperative follow-up. Initial periodontal therapy included supragingival scaling and subgingival curettage. Non-surgical treatment of tooth #36 followed, using carbon fiber curettes and oral hygiene instruction. Surgical procedures involved: ① Removal of the abutment-crown complex; ② Carbon fiber curettage and titanium brush debridement; ③ Er:YAG laser surface decontamination; ④ Placement of healing abutment with Bioss bone graft and collagen membrane; ⑤ Nd:YAG laser soft tissue treatment . At 6-month follow-up, successful bone regeneration was observed. The original abutment-crown was reinserted with occlusal adjustment to light contact. At the 3-year postoperative follow-up, the peri-implant soft and hard tissues remained stable. Peri-implantitis is a common complication of dental implants. In this case, peri-implantitis arose from patient-related factors (periodontal history, poor oral hygiene, insufficient keratinized gingiva, lack of regular maintenance) and iatrogenic factors (excessive occlusal load on #36 due to missing #37). Following the EFP S3 guidelines (2023), a staged infection control protocol was implemented: initial therapy → non-surgical treatment → surgical intervention. This approach successfully eliminated peri-implant infection and achieved favorable tissue regeneration. Regular follow-ups and oral hygiene maintenance are critical for peri-implantitis prevention. If peri-implantitis occurs, treatment should adhere to evidence-based guidelines, progressing from non-surgical to surgical interventions in a staged approach.