Resective therapy
Is used to reduce pockets, correct negative osseous architecture and rough implant surfaces and increase the area of keratinized gingival if needed.
Apically positioned flaps and osseous resective therapy is used to correct the horizontal bone loss and moderate vertical bone loss (<3mm) and to reduce the overall pocket depth. Let us discuss the surgical procedure now. A full thickness flap is raised to access the surgical area. Degranualution of the surgical defect is done while taking care that the metallic instrument does not contact the implant surface. Implant surface is now detoxified and prepared. . Then Surface Polishing or Implantoloplasty is carried out. It is done to arrest the progression of the disease and achieve a maintainable site for the patient. For this purpose, all implant surfaces that are smooth and clean coronal to the bone level are preferred. Therefore, surfaces with threads or roughened topography such as HA are indicated for alterations with high-speed diamond burs and polishers to produce a smooth continuous surface. Copious irrigation for cooling purposes is used while the implant topography is being modified.
It is very vital to understand that Implantoplasty is done only during respective surgery and not regenerative surgery. This is done as metal particles could interfere with the regeneration of bone tissue. Peri-implant bone defects with predominantly horizontal or one wall topographies can be treated resulting in healthy shallow pockets post surgery.