North Texas Dentistry Volume 9 Issue 5 2019 ISSUE 5 DE | Page 24

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CLINICAL EVALUATION
Clinical evaluation revealed a generalized healthy periodontium with
no caries, but mild incisal wear on anterior teeth due to trauma from
occlusion. Implant #8 had an acute peri-implant abscess with a drain-
ing sinus tract and tenderness to palpation. CBCT scan evaluation
shows more than two-thirds of the implant perforating through the
buccal plate.
INITIAL PRESENTATION
Ruben Ovadia, DDS, MS
Dr. Ruben Ovadia is a Board Certi-
fied periodontist and Diplomate of
the American Board of Periodon-
tology with a private practice lim-
ited to periodontics and dental
implants in Dallas, Texas. Dr. Ova-
dia has presented his clinical work
and research about topics related
to Dental Implants and Periodontal Disease both nationally and
internationally in Europe and Asia. He is an active member of
many professional associations and has written several articles
in scientific journals and publications. In addition to his peri-
odontal practice, Dr. Ovadia is an assistant professor and clinical
instructor at Baylor College of Dentistry in Dallas.
INITIAL CBCT
PROCEDURE
500mg Amoxicillin TID was prescribed 3 days prior to surgery and
7 days post-op. Original crown was removed and a full thickness flap
elevation was done to have access to the implant. A torque test of
45 Ncm confirmed adequate osseointegration.
Peri-Implant Abscess
THE PATIENT
A 43-year-old Caucasian female with a healthy medical history and
NKDA presented with pain and inflammation around Implant #8. The
implant was placed two years ago by her general dentist.
The patient's chief complaint was, “Everything was OK with my implant
until I felt a sharp edge under my nose, it got painful and noticed a
pimple in my gum.”
24 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
FULL THICKNESS FLAP
Decision was made to attempt to save the implant by doing a signif-
icant bone reconstruction utilizing PRF (Platelet Rich Fibrin) tech-
nology. Phlebotomy was done to collect six tubes of venous blood
which was placed in a centrifuge machine.