Soft tissue grafting has emerged as a valuable technique to address these complications and enhance the esthetic and functional outcomes of dental implants. This presentation reviews the current literature on the management of peri-implant deformities using mainly soft tissue grafting techniques. A treatment-driven classification will be presented, consisting of three different levels of complexity. Clinical recommendations pertaining to the prosthetic and surgical management of each type of peri-implant marginal mucosal defect will be illustrated with practical examples, facilitating decision-making processes in daily practice.

This presentation will focus on the selection of regenerative approaches in the treatment of peri-implant defects. Open versus closed healing approaches using different graft materials and growth factors will be demonstrated. Surface decontamination is an essential part of the success of this therapy and implant macro as well micro design plays an important role of the success.
 

Non-confined, vertical defects around peri-implantitis involved implants are considered to be the most challenging. This presentation will also discuss surgical approaches treating these demanding defects around implants. A decision tree of techniques selection based on defect type when treating peri-implantitis will be presented.

Many of the peri-implantitis lesions treated today are complex in their bone morphology as the remaining walls surrounding the affected dental implant are not always circumferential i.e. clot/graft containing in their configuration. Moreover, the disease process may also leave portions of the implant body supracrestal to any remaining lesion. This is due to a variety of factors including the position of the dental implant. In those areas where regenerative treatment is not possible, it may be best to decontaminate the surface with implantoplasty and manage the remaining lesion through resection. The goal is to establish heath with cleansability. On the other hand, there may be a number of combination lesions where a hybrid approach i.e. regeneration with resection should be provided. This lecture will explore the reasons and benefits to using implantoplasty as a monotherapy as well as in combination with regeneration.