Epithelial Free Graft for Peri-Implantitis Cases: Clinical Application

This clinical report presents a case in which we used an epithelial free graft to manage advanced peri-implantitis in a 39-year-old patient. She arrived at our clinic with pain around mandibular implants and ongoing bleeding while brushing.

Clinical Findings and Diagnosis

The patient had received six implants in the mandible four years earlier at another practice. She wore a fixed prosthesis but reported progressive discomfort and inflammation.

After removing the prosthesis, we found an alarming absence of keratinized and attached mucosa around all implants. The most severe peri-implantitis affected sites 32 and 42, as confirmed by clinical photos.

Surgical Approach: Bilateral Epithelial Free Graft

To treat this, we performed a bilateral epithelial free graft using tissue harvested from the palate. Our goal was to reestablish a band of attached mucosa around each implant to control inflammation and stabilize the tissues.

We follow a strict protocol of using autologous grafts, which integrate predictably and offer reliable outcomes in peri-implantitis management.

📎 Reference: Soft tissue grafting in implant dentistry (PubMed)

Postoperative Results and Maintenance Plan

At the 6-week check-up, the patient reported substantial improvement. Clinically, the grafts appeared stable, with clear reformation of attached gingiva.

During her next visit, we’ll assess whether polishing of exposed threads is needed to improve hygiene and minimize plaque accumulation.

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