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ePaper created 2017-10-13, 10:01:15 | version 1.38.0
Fig. 4 Teeth affected by periodontitis in the left lower jaw. Fig. 5 Root resection therapy performed on the left mandibular first molar. Fig. 6 The 2 implants in the left upper jaw affected by periimplantitis. Fig. 7 Removal of the implants. Fig. 8 Periimplant bone loss at the left mandibular second molar. Fig. 9 The left mandibular second molar site shown fully recovered. C r o s s - a r c h i m p l a n t - s u p p o r t e d f i x e d r e s t o r a t i o n Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 9 of periimplant bone loss were also observed at the 6-year follow-up at the right mandibular second molar implant (Fig. 8), related to retained cement that was noted about 6 months after a recementation of the splinted crowns. A flap was raised at the right mandibular molar area, then the exposed TiUnite surface was decontaminated with citric acid and hard-tissue defect walls and soft-tissue excess were reduced as part of flap closure. At the 7-year follow-up examination, subgingival irrigation with minocycline hydrochloride microspheres (Arestin, OraPharma, Valeant Pharmaceuticals International, Laval, Quebec, Canada) was per- formed. At the year 8 visit, the right mandibular second molar site had fully recovered bone ref- ormation (Fig. 9). Although the patient had active periodontal disease activity, good clinical (Figs. 10 & 11) and radiographic (Fig. 12) out- comes were illustrated at the 8-year follow-up visit, owing to the impact of supportive peri- odontal therapy. At the year 13 visit, the second molar still remained stable in response to intervention, with a full recovery of historic bone loss that was once about 2 mm beyond the machined collar. Good clinical (Figs. 13 & 14) and radio- graphic (Figs. 15a & b) outcomes were recorded at the 13-year follow-up visit, owing to good oral hygiene maintenance and regular recall. Journal of Oral Science & Rehabilitation Volume 3 | Issue 3/2017 51