Dealing with complications

The final case presented involved a 52-year-old woman who was referred to the clinic to have two implants placed (to replace missing left mandibular molars). Two months after surgery, significant crestal bone loss was observed. There are multiple factors which could have been the cause (Oh et al., 2002).

The approach selected to combat this involved decontaminating the surface in order to promote re-osseointegration (Mellado-Valero et al., 2013). An Er:Yag laser was used, and the area was then grafted. Two months later, the peri-implant bone had regenerated and prosthetic treatment was completed.

Main concepts presented and evidence

• early crestal bone loss around implants is often greater during the healing period and first year of function than the bone loss that occurs in the following years (evidence type I: RCT)
• one of the key ways to prevent early bone loss is by controlling insertion torque (evidence type III: clinical experience)
• the Er:Yag laser only demonstrated slight advantages for intraoral bone grafting procedures. Combined therapy may provide an effective treatment approach for peri-implant disease (evidence type II: prospective studies)