The aim of the present case report is to present the four-year results following open flap surgery and additional application of an enamel matrix protein derivative for the treatment of intrabony defects caused by peri-implantitis. Three patients (one female and two males) diagnosed with late peri-implantitis and presenting deep crater like intrabony defects, were treated with open flap debridement (OFD), implant surface decontamination with EDTA and application of an enamel-matrix-protein derivative (EMD). One year after therapy a substantial reduction of probing depth (PD), clinical attachment level (CAL) gain and radiographic bone fill were observed in all three cases. The obtained results were maintained at a stable level for all 3 patients over a period of 4 years. The results of the present case report study indicate that OFD followed by decontamination of the implant surface with EDTA and subsequent application of EMD may result in positive clinical and radiographic results that can be maintained over a period of 4 years.
Keywords: peri-implantitis, surgical therapy, enamel matrix protein derivative, case reports