Application of enamel matrix derivative and deproteinized bovine bone for the treatment of peri-implantitis after decontamination with an ultrasonic scaler: A case report

• Published in: Medicine (Baltimore) 2018-11, Vol.97 (48), p.e13461-e13461
• Main Author: Park, Jun-Beom
• Format: Article
• Language: English
• Subjects: Animals; Biological Products - therapeutic use; Bone Matrix - transplantation; Bone Regeneration; Cattle; Clinical Case Report; Decontamination - methods; Dental Enamel - transplantation; Dental Implants - adverse effects; Dental Scaling - methods; Humans; Hydroxyapatites - therapeutic use; Male; Middle Aged; Minerals - therapeutic use; Peri-Implantitis - etiology; Peri-Implantitis - therapy; Ultrasonic Therapy - methods
• ISSN: 0025-7974; 1536-5964
• DOI: 10.1097/MD.0000000000013461

The purpose of this report is to present a case of peri-implantitis with successful regeneration. The surface of the affected dental implant was decontaminated with an ultrasonic scaler and treated with bovine-derived hydroxyapatite and enamel matrix derivative. A 52-year-old male was referred for evaluation of a dental implant placed in the mandibular right second premolar area. The radiographic evaluation showed the loss of supporting bone around the dental implant. Bleeding upon probing and suppuration were observed, with the deepest probing depth at 6 mm. The area was firstly treated with a nonsurgical approach. After re-evaluation, a full-thickness flap was elevated. The area was well debrided using various instruments, including curettes and an ultrasonic scaler. The defect area was grafted with bovine-derived hydroxyapatite and enamel matrix derivative. Histopathologic evaluation revealed chronic inflammation with fibrosis and calcification. The evaluation at 2 years and 3 months after surgery showed that the prosthesis was functioning well. Bleeding upon probing and suppuration was not noted, and reduction of probing depth was seen, with the deepest depth at 4 mm. The area showed maintenance of graft material with increased radiopacity around the dental implant. In conclusion, a case of peri-implantitis can be successfully treated with bovine-derived hydroxyapatite and enamel matrix derivative after surface decontamination with an ultrasonic scaler.