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2026 Vol.30, Issue 3 Preview Page

Clinical or Case Report

Simultaneous Implant Placement with Surgical Management of Adjacent Compromised Sites: Case Reports with 3-Year Follow-Up
Seung-Ju Lee1
,
Young-Chang Ko1
,
Ki-Tae Koo2
,
Yong-Moo Lee2
,
Dongseob Lee3
,
Jungwon Lee4*
1Doctor, Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
2Professor, Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
3Clinical Professor, National Dental Care Center for Persons with Special Needs, Seoul National University Dental Hospital, Seoul, Korea
4Assistant Professor, Department of Periodontology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
*Corresponding Author
30 September 2026. pp. 169-184
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Abstract

Compromised sites due to periodontal or peri-implant disease adjacent to a planned implant site may increase the risk of peri-implant disease and complicate implant therapy. Conventional management generally involves staged treatment, in which the adjacent periodontal or peri-implant lesion is treated before implant placement, resulting in additional surgical procedures and a prolonged treatment period. This report presents two cases in which implant placement was performed simultaneously with the surgical treatment of compromised adjacent sites. In the first case, an implant was placed adjacent to a tooth with a residual periodontal intrabony defect following non-surgical periodontal therapy. In the second case, an implant was placed adjacent to the existing implant affected by peri-implantitis. Following flap elevation, thorough debridement of the adjacent lesions and implant placement were performed, and the defects were grafted with collagenated deproteinized bovine bone mineral. Prosthetic rehabilitation was completed after a 5-month healing period. At the 3-year follow-up, both patients demonstrated stable peri-implant conditions without signs of inflammation or progressive bone loss. Radiographic bone fill was observed at the treated adjacent sites, while the newly placed implants remained functionally stable. Within the limitations of these two cases, simultaneous implant placement and surgical treatment of adjacent periodontal or peri-implant lesions may represent a feasible treatment strategy for selected patients.

Keywords
Bone regeneration
Debridement
Dental implants
Peri-implantitis
Periodontitis
References
1

Broers DLM, Dubois L, de Lange J, Su N, de Jongh A. Reasons for tooth removal in adults: a systematic review. Int Dent J 2022;72:52-7.

10.1016/j.identj.2021.01.01133648772PMC9275356
2

Graetz C, Mann L, Krois J, Sälzer S, Kahl M, Springer C, et al. Comparison of periodontitis patients' classification in the 2018 versus 1999 classification. J Clin Periodontol 2019;46:908-17.

10.1111/jcpe.13157
3

Grassi M, Tellenbach R, Lang NP. Periodontal conditions of teeth adjacent to extraction sites. J Clin Periodontol 1987;14:334-9.

10.1111/j.1600-051X.1987.tb00980.x
4

Quirynen M, Vogels R, Peeters W, van Steenberghe D, Naert I, Haffajee A. Dynamics of initial subgingival colonization of 'pristine' peri-implant pockets. Clin Oral Implants Res 2006;17:25-37.

10.1111/j.1600-0501.2005.01194.x
5

Cobb CM, Sottosanti JS. A re‐evaluation of scaling and root planing. J Periodontol 2021;92:1370-8.

10.1002/JPER.20-0839
6

Sanz M, Herrera D, Kebschull M, Chapple I, Jepsen S, Beglundh T, et al. Treatment of stage I–III periodontitis—The EFP S3 level clinical practice guideline. J Clin Periodontol 2020;47:4-60.

10.1111/jcpe.1329032383274PMC7891343
7

Cortellini P, Tonetti MS. Long‐term tooth survival following regenerative treatment of intrabony defects. J Periodontol 2004;75:672-8.

10.1902/jop.2004.75.5.672
8

Roos‐Jansåker AM, Lindahl C, Persson GR, Renvert S. Long‐term stability of surgical bone regenerative procedures of peri‐implantitis lesions in a prospective case–control study over 3 years. J Clin Periodontol 2011;38:590-7.

10.1111/j.1600-051X.2011.01729.x
9

Fickl S, Kebschull M, Schupbach P, Zuhr O, Schlagenhauf U, Hürzeler MB. Bone loss after full‐thickness and partial‐thickness flap elevation. J Clin Periodontol 2011;38:157-62.

10.1111/j.1600-051X.2010.01658.x
10

Bazrafshan N, Darby I. Retrospective success and survival rates of dental implants placed with simultaneous bone augmentation in partially edentulous patients. Clin Oral Implants Res 2014;25:768-73.

10.1111/clr.12185
11

Gagnier JJ, Kienle G, Altman DG, Moher D, Sox H, Riley D, et al. The CARE guidelines: consensus-based clinical case report guideline development. J Clin Epidemiol 2014;67:46-51.

10.1016/j.jclinepi.2013.08.003
12

Mayhew D, Mendonca V, Murthy B. A review of ASA physical status–historical perspectives and modern developments. Anaesthesia 2019;74:373-9.

10.1111/anae.14569
13

Monje A, Pons R, Insua A, Nart J, Wang HL, Schwarz F. Morphology and severity of peri-implantitis bone defects. Clin Implant Dent Relat Res 2019;21:635-43.

10.1111/cid.12791
14

Ramseier CA. Diagnostic measures for monitoring and follow-up in periodontology and implant dentistry. Periodontol 2000 2024;95:129-55.

10.1111/prd.12588
15

Lin CY, Kuo PY, Chiu MY, Chen ZZ, Wang HL. Soft tissue phenotype modification impacts on peri-implant stability: a comparative cohort study. Clin Oral Investig 2023;27:1089-100.

10.1007/s00784-022-04697-236048254PMC9433516
16

Sanz M, Schwarz F, Herrera D, McClain P, Figuero E, Molina A, et al. Importance of keratinized mucosa around dental implants: Consensus report of group 1 of the DGI/SEPA/Osteology Workshop. Clin Oral Implants Res 2022;33 Suppl 23:47-55.

10.1111/clr.13956
17

Halperin-Sternfeld M, Zigdon-Giladi H, Machtei EE. The association between shallow vestibular depth and peri-implant parameters: a retrospective 6 years longitudinal study. J Clin Periodontol 2016;43:305-10.

10.1111/jcpe.12504
18

Silness J, Loe H. Periodontal disease in pregnancy. II. correlation between oral hygiene and periodontal condition. Acta Odontol Scand 1964;22:121-35.

10.3109/00016356408993968
19

Mühlemann HR, Son S. Gingival sulcus bleeding--a leading symptom in initial gingivitis. Helv Odontol Acta 1971;15:107-13.

20

Mombelli A, van Oosten MA, Schurch E, Jr., Lang NP. The microbiota associated with successful or failing osseointegrated titanium implants. Oral Microbiol Immunol 1987;2:145-51.

10.1111/j.1399-302X.1987.tb00298.x
21

O'Leary TJ, Drake RB, Naylor JE. The plaque control record. J Periodontol 1972;43:38.

10.1902/jop.1972.43.1.38
22

De Smet E, Jacobs R, Gijbels F, Naert I. The accuracy and reliability of radiographic methods for the assessment of marginal bone level around oral implants. Dentomaxillofac Radiol 2002;31:176-81.

10.1038/sj/dmfr/4600694
23

Lee C, Kim S, Kim J, Namgung D, Kim K, Ku Y. Supplemental periodontal regeneration by vertical ridge augmentation around dental implants. A preclinical in vivo experimental study. Clin Oral Implants Res 2019;30:1118-25.

10.1111/clr.13525
24

Lee J, Lee D, Ko Y, Lee YM. Minimally invasive regenerative surgery by peri-implant excision and regenerative surgery (PERS) in peri-implantitis: one-year result on three cases. J Oral Implantol 2023;49:257-64.

25

de Tapia B, Ribeiro-Amaral T, Mor C, Nart J, Valles C. Peri-implantitis reconstructive treatment implementing a titanium brush: 5-year extension results from a randomized clinical trial. J Periodontol 2025;96:1213-26.

10.1002/JPER.24-067340153369PMC12671692
26

Park SH, Kim DB, Kim DM, Sanz-Martin I, Sanz-Sanchez I, Derks J, et al. Implantoplasty vs. rotating titanium brushes in the surgical treatment of peri-implantitis: a 1-year randomised controlled clinical trial. J Clin Periodontol 2026;53:244-55.

10.1111/jcpe.7005641117707PMC12803560
27

Nibali L, Sultan D, Arena C, Pelekos G, Lin GH, Tonetti M. Periodontal infrabony defects: systematic review of healing by defect morphology following regenerative surgery. J Clin Periodontol 2021;48:100-13.

10.1111/jcpe.13381
28

Schwarz F, Sahm N, Schwarz K, Becker J. Impact of defect configuration on the clinical outcome following surgical regenerative therapy of peri-implantitis. J Clin Periodontol 2010;37:449-55.

10.1111/j.1600-051X.2010.01540.x
29

Shahbazi A, Allen EP, Gschwindt S, Murphy KG, Baksa G, Sculean A. Surgical considerations based on oral and periodontal vascularization. Periodontol 2000 2026;99:1-25.

10.1111/prd.70065
30

Noelken R, Al-Nawas B. Bone regeneration as treatment of peri-implant disease: a narrative review. Clin Implant Dent Relat Res 2023;25:696-709.

10.1111/cid.13209
31

Wang J, Cui W, Zhao Y, Lei L, Li H. Clinical and radiographic evaluation of Bio-Oss granules and Bio-Oss Collagen in the treatment of periodontal intrabony defects: a retrospective cohort study. J Appl Oral Sci 2024;32:e20230268.

10.1590/1678-7757-2023-026838198370PMC11019911
32

Lee D, Choi JU, Ko YC, Koo KT, Seol YJ, Lee YM, et al. Does defect configuration affect the outcomes of alveolar ridge preservation? An experimental in vivo study. J Periodontal Implant Sci 2025;55:35-49.

10.5051/jpis.240148007439439106PMC11885871
33

Ko YC, Koo KT, Li L, Lee D, Lee YM, Seol YJ, et al. Clinical evaluation of implants placed within or beyond the boundaries of the alveolar ridge preservation: a retrospective case series with 10 weeks of observations in 28 patients. J Periodontal Implant Sci 2025;55:50-61.

10.5051/jpis.240080004039058351PMC11885866
34

Alauddin MS, Abdul Hayei NA, Sabarudin MA, Mat Baharin NH. Barrier Membrane in Regenerative Therapy: A Narrative Review. Membranes (Basel) 2022;12:444.

10.3390/membranes1205044435629770PMC9143924
35

Lee D, Ko YC, Koo KT, Seol YJ, Lee YM, Lee J. A flexible membrane may improve bone regeneration by increasing hydrophilicity and conformability in lateral bone augmentation. Biomater Res 2024;28:0113.

10.34133/bmr.011339559494PMC11570787
36

Monje A, Pons R, Nart J, Miron RJ, Schwarz F, Sculean A. Selecting biomaterials in the reconstructive therapy of peri-implantitis. Periodontol 2000 2024;94:192-212.

10.1111/prd.12523
37

Khoury F, Keeve PL, Ramanauskaite A, Schwarz F, Koo KT, Sculean A, et al. Surgical treatment of peri-implantitis - consensus report of working group 4. Int Dent J 2019;69 Suppl 2:18-22.

10.1111/idj.1250531478576PMC9379045
38

Astolfi V, Gómez-Menchero A, Ríos-Santos JV, Bullón P, Galeote F, Ríos-Carrasco B, et al. Influence of removing or leaving the prosthesis after regenerative surgery in peri-implant defects: retrospective study: 32 clinical cases with 2 to 8 years of follow-up. Int J Environ Res Public Health 2021;18:645.

10.3390/ijerph1802064533451161PMC7828701
39

Wiltfang J, Zernial O, Behrens E, Schlegel A, Warnke PH, Becker ST. Regenerative treatment of peri-implantitis bone defects with a combination of autologous bone and a demineralized xenogenic bone graft: a series of 36 defects. Clin Implant Dent Relat Res 2012;14:421-7.

10.1111/j.1708-8208.2009.00264.x
40

Mercado F, Ivanovski S. Surgical therapy for peri-implantitis using deproteinised bovine bone mineral with 10% collagen, enamel matrix derivative and doxycycline: a prospective cohort 10-year implant study. J Clin Periodontol 2026;1-10.

10.1111/jcpe.7017542492913PMC13581473
41

Koldsland OC, Wohlfahrt JC, Aass AM. Surgical treatment of peri-implantitis: prognostic indicators of short-term results. J Clin Periodontol 2018;45:100-13.

10.1111/jcpe.12816
42

Herrera D, Berglundh T, Schwarz F, Chapple I, Jepsen S, Sculean A, et al. Prevention and treatment of peri-implant diseases-The EFP S3 level clinical practice guideline. J Clin Periodontol 2023;50 Suppl 26:4-76.

10.1111/jcpe.13823
43

Lee D, Ahn S, Park JY, Lee SJ, Lee YM, Koo KT, et al. Supportive periodontal therapy improves implant survival in patients with a history of periodontitis: a retrospective multicenter cohort study of 3555 implants. Clin Oral Implants Res 2026;37:590-611.

10.1111/clr.7010341691501PMC13155266
44

Aichelmann-Reidy ME, Reynolds MA. Predictability of clinical outcomes following regenerative therapy in intrabony defects. J Periodontol 2008;79:387-93.

10.1902/jop.2008.060521
45

Schwarz F, John G, Schmucker A, Sahm N, Becker J. Combined surgical therapy of advanced peri-implantitis evaluating two methods of surface decontamination: a 7-year follow-up observation. J Clin Periodontol 2017;44:337-42.

10.1111/jcpe.12648
Information
  • Publisher :The Korean Academy of Oral & Maxillofacial Implantology
  • Publisher(Ko) :대한구강악안면임플란트학회
  • Journal Title :Journal of implantology and applied sciences
  • Journal Title(Ko) :대한구강악안면임플란트학회지
  • Volume : 30
  • No :3
  • Pages :169-184
  • Received Date : 2026-07-15
  • Revised Date : 2026-08-15
  • Accepted Date : 2026-08-29
  • DOI :https://doi.org/10.32542/implantology.2026014
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