Regenerative Treatment of Peri-Implantitis Following Implant Surface Decontamination With Titanium Brush and Antimicrobial Photodynamic Therapy: A Case Series With Reentry

Peri-implantitis is a biofilm-induced inflammatory condition that affects both hard and soft tissues around osseointegrated dental implants.¹  Soft-tissue inflammation is clinically recognized by peri-implant bleeding on probing (pBOP) associated with increased peri-implant pocket probing depth (pPD), while progressive bone loss is identified on radiographs.²  Unfortunately, emerging evidence suggests that pBOP and pPD may be considered as poor indicators of ongoing peri-implant pathology with a considerable false-positive rate together with a risk of iatrogenic damage by probing of dental implants.^3,4  Therefore, data gathered from pBOP and pPD should be associated with the radiographic assessment of crestal bone levels to obtain an incontrovertible diagnosis. It has been claimed, however, that intraoral radiography lacks the accuracy for assessing interproximal bone defect morphology⁵  and often underestimates the intrasurgical bone loss at the correspondent site,⁶  since the intraoperatively measured peri-implant bone levels tend to be more apical than...