Peri-implantitis due to diabetes and poor condition

This is a photo from the initial examination in 2013, with a 72-year-old male patient.

Four implants were placed in the maxilla, and a bar over denture was fabricated as shown in the picture. The existing implants were left in place for now, as the patient did not wish to remove them.

Intraoral photo.

This is a photo from 2016.

This is a photo from 2018.

At this time, the existing left implants were removed.

In the 2020 photo, signs of peri-implantitis are visible around the implants on the right side.

The patient appeared to have progressed diabetes and poor oral hygiene.

Bone grafting was performed after thorough cleansing using a titanium brush and detoxification with TC (tetracycline).

After suturing:

Preoperative radiograph:

Postoperative radiograph:

One-year postoperative photo: The patient's discomfort has decreased, but complete bone formation as expected has not yet occurred.

However, this time there is pus coming out on the left side, and the gingiva is showing signs of swelling.

Based on the radiographic findings, since bone resorption doesn't seem severe, we have decided to proceed with gingivectomy for now.

This is a photo of the gingivectomy.

I used a Bovie.

Before surgery.

One month after surgery.

However, it is still ongoing, and considering the patient's age, more careful follow-up may be necessary.