Is it possible to do a bone graft around an existing implant?

[two_dollars]

I have bone loss around my 20+ year old implant located at 24/25 which has also affected my tooth at 26.

I've seen some medical papers and research about bone grafting/regeneration around existing teeth and in some cases implants, possibly coupled with some laser cleaning for any existing bacteria, etc... I'm not sure if my situation is too severe for that treatment. I've only seen this treatment discussed in research but nothing pointing to a particular practice (in the US) where something like that could be evaluated.

If the treatment is potentially viable and even a chance it could work in my situation, could anyone provide a recommendation for where I could look further into this.

Even if it were possible, I understand it might not be the best solution but what was offered as the best solution came in at 30k for removal of implant and all neighboring incisors, bone graft/tissue Regen, two new implants at #23 and #26 and an implant bridge. I had a bone scan done and then periodontist thought 23/26 had adequate bone for this treatment, although I'd still probably have to go with a canine anchored bridge and maybe revisit the implant later if possible.

 

[MattKW]

There is no way of treating the contaminated surface of that implant, it simply has to go. I'd keep it simple for a while, maybe a Valplast single tooth denture. Unfortunately, there has been severe bone loss about adjacent teeth, esp #24 (FDI 31), and I'd like to see how things heal up over next 6 months.
Given that you have otherwise excellent teeth, I would consider it very unwise and unethical to make a standard bridge on virgin teeth. I also think looking at re-implantation down the road is wishful thinking. There is a possibility of a minimally invasive cantilevered Marylands bridge, or even a simple cantilevered composite tooth.

 

[two_dollars]

A friend of a friend is a dentist. He said it would be best to do the removal and graft and a temp bridge. After things heal, you could see if an implant would be viable.

He suggested the canine tooth anchored bridge because he thought putting implants in #26 and #23 has too high a possibility of later failure. He said the canine bridge could last 10-15 years and then I would need to have implants done at #22 and #27 with a 6 tooth bridge.

Since the implant that needs to go has a crown that resembles two teeth and the old root canal tooth next to it also needs to go, how would a Maryland bridge work? I presume the canine at #27 would have to support one side and the tooth at #23 would have to support the other. #23 seems barely anchored on its own. Could a Maryland bridge be designed to act/look like two or three teeth?

 

[MattKW]

Yes, it is possible to do a bone graft around an existing dental implant. This procedure is called a "bone augmentation" or "ridge augmentation." It involves adding bone material to the area around the implant to enhance its stability and support. Bone grafts can help address issues like bone loss or gum recession around the implant, improving the overall health and aesthetics of the dental implant site. Your dentist or oral surgeon can assess your specific situation and determine if a bone graft is necessary and suitable for your implant.

No, the original implant surface was specially prepared for sterile insertion into the bone. Once there has been peri-implantitis, bone loss, and exposure of the threads as in this case, then the surface is contaminated with bacteria and the implant prognosis is hopeless.