Introduction
This report describes the management of peri-implantitis in a systemically healthy female patient. The second maxillary premolar had been replaced with an implant-supported restoration following sinus floor elevation and GBR. Clinical examination revealed inflammation around the implant, with radiographic evidence of a circumferential bone defect.
The patient's primary goal was to preserve the implant and restore peri-implant health. The treatment approach combined non-surgical and surgical modalities. Implant surface decontamination was performed using GalvoSurge®, an electrolytic cleaning system that removes bacterial biofilm by generating hydrogen bubbles at the implant surface through the application of a low-voltage current in an electrolyte solution. This method allows thorough and atraumatic cleaning, which is particularly useful in complex or deep defects. Reconstructive therapy with guided bone regeneration (GBR) was also carried out.
Long-term success in such cases is closely linked to the patient’s commitment to maintaining excellent oral hygiene and attending regular follow-up appointments. With ongoing compliance and appropriate maintenance care, the prognosis for preserving the implant and achieving stable, healthy peri-implant tissues remains highly favorable.
Initial situation
A systemically healthy female patient without medication presented with inflammation of the soft tissues around implant #15, expressing a desire to save the implant and restore peri-implant health. Her dental history included the loss of tooth #15, which was subsequently replaced with a dental implant placed with sinus floor elevation (SFE) and simultaneous guided bone regeneration (GBR). The implant was restored with a screw-retained single-unit crown.
Intraorally, the patient presented overall adequate oral hygiene. The mucosa surrounding the implant was edematous but showed no exposure of the implant shoulder (Fig. 1). After the crown was removed, inflammation and increased probing depth with positive bleeding on probing (BOP) were observed (Figs. 2,3).
Radiographic examination revealed a circumferential peri-implant defect with bone resorption around implant #15, while the adjacent teeth showed a secure prognosis (Fig. 4).
The diagnosis was peri-implantitis affecting implant #15.
Treatment planning
The treatment workflow included:
- Non-surgical therapy.
- Surgical reconstructive peri-implantitis therapy with GalvoSurge® and GBR.
- Prosthetic rehabilitation by means of the pre-existing screw-retained crown.
- Follow-up appointments.
Surgical procedure
The screw-retained single-unit crown on implant #15 was removed. Subsequently, under local anesthesia, a full-thickness mucoperiosteal flap was raised to allow proper access to the peri-implant defect. Intrasurgical buccal and occlusal views following granulation tissue removal revealed a circumferential peri-implant osseous defect morphology (Figs. 5,6).
Electrolytic decontamination of the implant surface was performed using the GalvoSurge®. This low-voltage method applies a current to the titanium implant while simultaneously irrigating the surface with an electrolyte solution. The process generates hydrogen ions (H⁺), resulting in the detachment of the bacterial biofilm from the implant surface (Figs. 7–10).
Intrasurgical photographs illustrate the reconstructive treatment of the peri-implantitis defect using a mixture of autogenous bone particles and a deproteinized bovine bone mineral (DBBM), as a bone substitute, covered by a resorbable collagen membrane. The membrane was stabilized with the aid of a closure screw to ensure positional stability during healing, and the site was closed with sutures (Figs. 11-15).
Submerged healing following a periosteal releasing incision was achieved. Postoperative oral hygiene instructions were provided to the patient. No provisional removable partial denture was delivered.
A Center of Dental Education (CoDE) is part of a group of independent dental centers all over the world that offer excellence in oral healthcare by providing the most advanced treatment procedures based on the best available literature and the latest technology. CoDEs are where science meets practice in a real-world clinical environment.
Prosthetic procedure
Clinical and periapical radiographic evaluation was performed 9 months after reconstructive peri-implantitis therapy and submerged healing. The pre-existing screw-retained single-unit crown was delivered (Figs. 16-18).
Treatment outcomes
Following surgical intervention, the peri-implant tissues around implant #15 showed marked clinical improvement. The reconstructive approach, supported by GalvoSurge® electrolytic decontamination and guided bone regeneration, led to the resolution of inflammation and reestablishment of stable peri-implant conditions. At the 9-month follow-up, soft tissue healing was uneventful, and the implant site appeared clinically healthy. The patient expressed satisfaction with the treatment outcome. Continued success will depend on the patient’s adherence to individualized oral hygiene measures and regular maintenance visits, which remain critical for long-term peri-implant health.
Author’s testimonial
This case reinforced the importance of continuous long-term monitoring and comprehensive, individualized approach to peri-implantitis. The use of GalvoSurge® provided an effective and minimally invasive method for implant surface decontamination.