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Article: Volume 47 Number 2 Page 115 - February 2020

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  Dental Update 475: 115-120

Periodontics:  Peri-implantitis: an Unusual Presentation

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Abstract: Rehabilitation with dental implants is not without post-placement complications, one of which is peri-implantitis. Peri-implantitis is a progressive inflammatory disease which affects the hard and soft tissues around a dental implant. The consequent bone resorption and reduced osseointegration significantly affects the long-term viability of the implant fixture. Without treatment, peri-implantitis can progress in an accelerating, non-linear pattern. The aetiology of peri-implantitis is debated in the literature. Consequently, over the last ten years there have been numerous consensus meetings debating this topic and various guidelines have been written and updated by experts in the field. There is extensive, sometimes conflicting, literature on the subject in the scientific journals. The aetiological factors involved and the management of the condition remains up for debate… In 2011, a new patient attended the University Dental Hospital of Manchester with nine Xive implants (Dentsply Sirona), four maxillary and five mandibular. For various reasons the maxillary implants were all restored, however, only three of the mandibular implants were restored and two were left buried. In 2016, the patient returned with signs and symptoms of peri-implantitis around the most mesial buried implant (LL6 region). The potential reasons why this may have occurred were investigated and forms this case report.

Clinical relevance: Peri-implantitis may be associated with apparently buried implants.

Author notes: Craig W Barclay, BDS, FDS RCPS, DRD RCS, MRD RCS, MPhil, PhD, FDS RCPS(Rest), Consultant Restorative Dentistry/Honorary Professor in Maxillofacial Rehabilitation, Associate Postgraduate Dental Dean for Specialist Training, Director of Education of MANDEC (email: and Emma Foster-Thomas, BDS(Hons), MFDS RCPS(Glasg), Academic Clinical Fellow in Restorative Dentistry, University Dental Hospital of Manchester, Higher Cambridge Street, Manchester M15 6FH, UK.

Objective: To describe an unusual presentation of peri-implantitis.