Management of a Severe Peri-implantitis Case Using Titanium Mesh Technique with Xenogenic Bone Substitute and Collagen Matrix: A 4-Year Follow-up.

A 64-year-old female patient was referred for the treatment of peri-implantitis around an implant at site 46. Bleeding on probing, excessive probing depth and extensive bone loss (more than 50% of the implant length) were evident around the implant. Moreover, the implant site suffered from a lack of keratinized mucosa at the buccal side. The patient received a sequence of cleaning with a titanium brush, decontamination with tetracycline paste, H2O2 and saline, titanium mesh placement, use of xenogenic bone substitute, and eventually, covering the area with a xenogenic collagen matrix. Four years' results showed favorable probing depth, bone gain (more than 80% of the implant length), lack of bleeding on probing, and formation of a keratinized mucosal rim at the buccal side. In the presented case, the mesh technique with xenogenic bone substitute and collagen matrix effectively manages a severe peri-implantitis case.