•Dental implant therapy has become a predictable treatment option for the oral reconstruction of missing teeth. However, implant failure may occur and the failed implant site presents a therapeutic challenge to the clinician, especially in the maxillary esthetic region.
•A 58-year-old male was presented with a chief complaint of purulent discharge over #9 implant site for 6 months.
•His medical history was hypertension under good control and he denied any drug allergy.
•His dental history revealed a #9-#11 bridge supported by two rough-surface implants on #9, #11 sites fabricated for more than 18 years.
•Oral examination revealed that there were some deep probing depth (≥5mm) over maxillary right and mandibular right posterior dentition with 10-20% bone loss on radiographic examination. The patient was diagnosed as generalized mild and localized moderate chronic periodontitis. After nonsurgical periodontal treatment and #2,3 guided tissue regeneration, the overall probing depths were within 3mm post-operative six months follow-up.
•The probing depth around #9 implant was about 10 mm, and probing depth of #11 implant was less than 3mm. In addition, #9 was detected with mobility III, pus discharge, gingival swelling and redness. Radiographic examination revealed #9 with severe bone loss, but no obvious bone loss and infection sign over #11 implant site.
•Based on lack of implant stability and extensive bone destruction, #9 implant prognosis was poor. Therefore, #9 implant was removed after separating the bridge unit between #9 and #10, and primary closure was performed. There was heavy calculus deposition on the implant surface and its diagnosis was “peri-implantitis caused implant failure”.