Case 1
“Fringe Benefits”
Larry Gelb, DDS
[email protected]
A 62 year old Caucasian female presented with severe peri-implant disease associated with #’s12-13 as well as radiographic attachment loss on the adjacent natural tooth #11. Probing depths ranged at intake from 7-15 mm’s with the area of greatest attachment loss on the palatal aspect of the #12 implant. There was no attachment loss on the distal of #11, despite the radiographic evidence of bone loss.
Initial discussion involved possible extraction of the implant bridge and adjacent tooth or LAPIP. The patient opted for the latter with the understanding that given the extent of bone loss, re-treatment might be indicated.
The case is as follows.
Figure 1
Figure 2
4/15/2014 (11 month post-op)
ibid.
Treatment was performed to the standards of the LAPIP protocol and the patient reported no morbidity during the healing phase. Not only was the implant issue resolved but the adjacent tooth (#11) benefited from the procedure as evidenced by the radiographs and charting.
LAPIP, although not as predictable as LANAP, given the fundamental lack of a connective tissue attachment and the difficulties in detoxifying the implant surface, has clearly been shown to be a viable option in the treatment of peri-implantitis. Like a natural dentition which requires periodic supportive therapy, LAPIP cases might benefit also by being placed on a yearly schedule for maintenance, all the more so, cases that have less than optimum outcome.