title: Treatment of an early implant failure according to the principles of guided tissue regeneration (GTR).
abstract: The present case report demonstrates the application of guided tissue regeneration (GTR) in combination with antimicrobial therapy for the treatment of an early implant failure. This treatment approach both prevented further loss of bone as well as led to the regeneration of lost bone. By means of color-converted digital subtraction images, remodelling of the tissues adjacent to the defect was documented as early as one month postsurgically. The images demonstrated "bone-fill" in the apical portion of the defect and resorptive changes at the bone crest. This case report demonstrates that combined regenerative and antimicrobial therapy may be a successful treatment approach restoring osseointegration of dental implants following loss of bone due to infection. Continuously increasing bone-fill inside the defect was documented when comparing the radiograph obtained immediately before the GTR procedure and at months 1, 2, 4, 5 and 6 of the healing period, respectively. Clinical measurement obtained at the time of the surgery and at the time of the membrane removal confirmed the radiographic evidence of bone-fill by demonstrating new tissue resistant to probing in close contact to the implant surface at the site of the previous defect. Antimicrobial therapy included an antibiotic regimen during the 1st month of healing as well as topical rinses with an antiseptic (chlorhexidine) over the entire healing period of 6 months. As a result of this treatment approach, the implant was saved and could be used as an abutment for a bridge reconstruction.
authors.affiliation: University of Berne, School of Dental Medicine.
authors.forename: B
authors.initials: B
authors.lastname: Lehmann
authors.forename: U
authors.initials: U
authors.lastname: Bragger
authors.forename: C H
authors.initials: CH
authors.lastname: Hammerle
authors.forename: I
authors.initials: I
authors.lastname: Fourmousis
authors.forename: N P
authors.initials: NP
authors.lastname: Lang
mesh_terms: D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002710:Chlorhexidine / Q000627:therapeutic use; D000044:Dental Abutments; D015921:Dental Implants / Q000009:adverse effects*; D003773:Dental Plaque / Q000517:prevention & control; D003830:Denture, Partial, Fixed; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D008875:Middle Aged; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000517:prevention & control; D011859:Radiography; D012086:Reoperation; D013382:Subtraction Technique
chemical_list: D000900:Anti-Bacterial Agents; D015921:Dental Implants; D002710:Chlorhexidine