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Case Reports in Dentistry
Volume 2018, Article ID 7174608, 9 pages
Case Report

Comprehensive Treatment of Severe Periodontal and Periimplant Bone Destruction Caused by Iatrogenic Factors

1College of Dental Medicine, University of Sharjah, Sharjah, UAE
2College of Dentistry, Ohio State University, Columbus, OH, USA
3College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
4School of Dentistry, University of Duesseldorf, Duesseldorf, Germany

Correspondence should be addressed to Gregor-Georg Zafiropoulos; ed.xmg@ifazgg

Received 20 September 2017; Accepted 3 December 2017; Published 30 January 2018

Academic Editor: Sukumaran Anil

Copyright © 2018 Gregor-Georg Zafiropoulos et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Dental implant success requires placement after periodontal therapy, with adequate bone volume, plaque control, primary stability, control of risk factors, and use of well-designed prostheses. This report describes the surgical and prosthetic management of a patient with severe iatrogenic periodontal/periimplant bone destruction. Methods. A 55-year-old female smoker with fixed partial dentures (FPDs) supported on teeth and implants presented with oral pain, swelling, bleeding, and a 10-year history of multiple implant placements and implants/prosthesis failures/replacements. Radiographs showed severe bone loss, subgingival caries, and periapical lesions. All implants and teeth were removed except implants #4 and #10 which served to retain an interim maxillary restoration. Bone defects were covered with nonresorbable dPTFE membranes. In the mandible, three new implants were placed and loaded immediately with a bar-retained temporary denture. Results. Seven months postoperatively, the bone defects were regenerated, and three additional mandibular implants were placed. All mandibular implants were splinted and loaded with a removable overdenture. Conclusions. In this case, periimplant infection and tissue destruction resulted from the lack of periodontal treatment/maintenance and failure to use evidence-based surgical and loading protocols. Combination therapy resolved the disease and the patient's severe discomfort while providing immediate function and an aesthetic solution.