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+A 46-year-old man, with no relevant pathological history, non-smoker. He underwent a fixed restoration on a single-tooth implant (ITI® SLA. Straumann. Walderburg-Switzerland) placed in the 3.6 zone. Six months after the crown was cemented, he attended a check-up without reporting any associated symptoms. Clinical examination revealed a slight reddening of the mucosa adjacent to the implant and a peri-implant pocket 6 mm deep, with slight bleeding on probing. The articulating paper showed premature contact on the prosthetic crown. The panoramic radiograph showed a radiolucent area in the marginal bone at 3.6.
+Occlusal grinding of the prosthetic crown was performed. Subsequently, a mucoperiosteal flap was raised from 3.5 to 3.7, revealing a fibrous soft tissue surround occupying a marginal peri-implant bone defect at 3.6. The pathological tissue was removed with plastic curettes and sent for pathological examination. The implant surface was decontaminated with 0.2% chlorhexidine gel for 2 minutes and irrigated with physiological saline. The flap was enlarged to access a lingual mandibular torus in the ipsilateral premolar area, which was extracted and particulated to serve as an autograft. The flap was repositioned and sutured with 3.0 silk. The patient was re-instructed in oral hygiene, ibuprofen 600 mg every 8 hrs x 4 days and mouthwash with chlorhexidine digluconate 0.12% twice daily x 2 weeks.
+Histopathological analysis showed epithelio-connective tissue with abundant lymphoplasmacytic and juxtaepithelial infiltrate. Under the superficial area, a dense fibro-connective tissue with few inflammatory cells was observed.
+Twelve months after surgical treatment, an X-ray showed marginal bone healing and a normal clinical appearance with no symptoms.
+