A 46-year-old male, with no relevant medical history, nonsmoker.
She underwent fixed rehabilitation on a single implant (ITI® SLA).
Straumann.
Walderburg-Switzerland) placed in zone 3.6.
Six months after cementing the crown, the patient came to control with no associated symptoms.
Clinical examination revealed slight redness of the mucosa adjacent to the implant and a 6 mm deep peri-implant pocket with mild bleeding on probing.
The role of joint showed premature contact with prosthetic crown.
Panoramic radiography showed a radiolucent area in the marginal bone at 3.6.
The prosthetic crown was occlusally carved.
Subsequently, a mucoperitic flap was raised from 3.5 to 3.7, a marginal flap of fibrous tissue occupying a peri-implant bone defect at 3.6.
The pathological tissue was removed with plastic curettes and sent for anatomopathological study.
The implant surface was tapered with 0.2% chlorhexidine gel for 2 minutes and irrigation with saline.
The flap was extended to access a lingual mandibular torus in ipsilateral premolar area, which was extracted and articulated to serve as a self-injection.
The flap was repositioned and sutured with 3.0 silk.
The patient was re-instructed in oral hygiene, ibuprofen 600 mg every 8 hrs x 4 days and eyedrops with chlorhexidine digluconate 0.12% twice a day x 2 weeks.
Histopathological analysis showed an epithelial connective tissue with abundant lymphoplasmacytic and juxtaepithelial infiltrate.
Dense fibroconnective tissue with few inflammatory cells was observed under the superficial area.
Twelve months after the surgical treatment, a radiograph showed marginal bone recovery and a normal clinical appearance, with no symptoms.
