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implants - international magazine of oral implantology

I overview Figs. 5–10_Simplified laser-assisted treatment of peri- implantitis with a pasty bone substitute: The original clinical image (Fig. 5) already shows the typical symp- toms of periimplantitis, which are confirmed after the creation of flaps (Fig. 6). A profound bone defect has de- veloped around the artificial abutment tooth; the granu- lation tissue is thoroughly removed (Fig. 7). A pasty bone substitute (Ostim® ) can be applied congruently with the defect (Fig. 8); the wound is then closed with a suture (Fig. 9). The last image of this case study (Fig. 10) shows the two-year check-up, which revealed a stable and aesthetically pleasing result. Proponents of this proce- dure (use of a pasty bone substitute) emphasise the sim- ple application of the bone substitute congruently with the defect and the advantage of a simplified treatment by foregoing the membrane (“periosteum is the best mem- brane”). Figs. 11–16_Laser-assisted treatment of periimplantitis with a bone substitute with improved application: The X-ray shows considerable vertical bone loss which has already reached the 50% mark of the coated portion of the implant mesially. After thorough cleaning of the im- plant surface, a laser light decontamination (here with diode laser light—wavelength 810 nm—in cw mode— 20 seconds—1 watt of power) is then performed in pure decontamination mode, non-ablative. Following applica- tion of the bone substitute, which is hardened with a bio linker in such a way that the particles can both be well applied and adhere to each other (easy-graft® ), the wound is then closed with a saliva-proof suture. The last image shows the check-up after two years, fortunately with no clinical problems. 22 I implants3_2013 Fig. 13 Fig. 14 Fig. 15 Fig. 16 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 Fig. 10 Fig. 11 Fig. 12