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International Journal of Implant Dentistry
Fig. 2 | International Journal of Implant Dentistry

Fig. 2

From: A modified surgical approach for hard and soft tissue reconstruction of severe periimplantitis defects: laser-assisted periimplant defect regeneration (LAPIDER)

Fig. 2

Treatment of a severe perimplantitis lesion at implant in the posterior left mandible according to LAPIDER technique.aHorizontal mucosal incision and split-flap preparation in apical direction.bSeparation of the periosteum at the level of the implant apex.cSubperiosteal coronal flap elevation and exploration and cleansing of the periimplant defect and the implant surface with the Er:YAG laser.dSubperiosteal grafting with connective tissue, which was harvested at the palate.eAugmentation of the bony defect with autogenous bone chips from the mandibular ramus.fCovering the grafted site by reflecting and suturing periosteum to periosteum. Wound closure is completed by mucosal suturing.gAt 6-month and 1-year follow-up examination, the signs of a periimplant infection are gone while the soft tissue level and thickness at the implant site are improved.hPeriapical X-rays pre-operatively at 6-month and at 1-year follow-up show the complete regeneration of the severe bony defect to the level of the implant shoulder.iCB-CT at 6 months reveals the bony regeneration to the level of the implant shoulder at the oral and the buccal aspects

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