Treatment of Ailing and Failing Dental Implants

From The Inaugural Issue:

Implant Dentistry Spring 1992

I will briefly discuss the treatment of the ailing dental implant (bone loss with pocketing but static at maintenance checks) an the failing dental implant (bone loss with pocketing, bleeding upon probing, purulence and evidence of continuing bone loss irrespective of therapy.)  In  these circumstances, the surface of the dental implant is contaminated with endotoxin, it must be detoxified before any regenerative therapy.  Studies have shown that citric acid is effective in detoxifying the hydroxyapatite-coated surfaces while tetracycline is more effective in detoxifying the metallic substrate fixtures.  Guided tissue regeneration is useful as a “barrier” to prevent exfoliation of the grafted material.  Both nonresorbable and resorbable materials have been used with great success.  Allografts (freeze-dried bone) and alloplasts (synthetic materials) may be used to achieve a sulcus of decreased depth and possibly some type of osseous regeneration.