Peri-implantitis on the anterior implant, peri-implant health on the posterio
Lack of KT on that implant as a risk factor
Hockey stick incision to avoid severing the hemidesmosomal-epithelial attachment to the healthy implant
Release of the lingual flap with stripping of the mylohyoid fibers for passing advancement
Note how the lingual flap is coronal to the abutment
Implant surface decontamination.
The most critical part of the entire procedure.
Implant specific cleaning approach
Membrane tacked into place for stability and then packed with 0.5cc Perio Glas morsels
Coronal flap advancement with periosteal release
Primary passive closure
Follow up of the case a couple of months later / Temporary Restoration
Restoration placed. Note how it was recountourned, now we can observe a healthy periodontal tissue around the implant and the restoration.
*Case Courtesy: George Kotsakis, Associate Professor (Perio), UTHSCSA, San Antonio, Texas