Management of Peri-implant Esthetic Complications

To achieve predictable and optimal outcomes, contemporary multidisciplinary treatment in periodontal patients should aim to achieve not only functional stability but also aesthetic harmony. The sequelae of periodontitis represent a complex therapeutic challenge. Among them, tooth replacement in the anterior zone with dental implants implies careful diagnosis and treatment planning in the context of interdisciplinary dentistry. In this lecture, protocols to facilitate the execution of interdisciplinary treatment plans to rehabilitate the aesthetic zone in patients with a history of periodontitis will be  presented, with a special focus on minimally invasive techniques.

Peri-implantitis is a plaque-associated pathological condition characterized by the mucosal inflammation along with progressive loss of supporting bone. Substantial evidence suggests that non-surgical therapy is of limited efficacy in arresting further bone loss, thus indicating the necessity of surgical intervention in the majority of patients diagnosed with peri-implantitis.

Achieving optimal treatment results in diverse clinical situations requires proper knowledge of indications and surgical performance of different surgical treatment modalities. This lecture will cover different surgical peri–implantitis treatment concepts, including reconstructive, resective, and combined surgical therapies, and the decisive factors in determining which surgical technique is most appropriate in different peri-implantitis cases. Important aspects of soft-tissue management and rationale for soft-tissue volume grafting following surgical peri-implantitis treatment, as well as the prognostic factors associated with treatment outcomes will be further discussed.