A Second Chance: Managing Late Implant Failure from Peri-Implantitis with Computer-Guided Bone Regeneration – A Clinical Case Report

The retreatment of failed dental implants presents a complex clinical challenge, particularly when complicated by peri-implantitis and bone loss. This case report describes the use of a fully digital, prosthetically driven approach to rehabilitate a posterior mandibular site following implant failure. A 44-year-old female patient underwent implant and tooth removal due to advanced peri-implantitis and periodontitis. After healing, a comprehensive digital workflow—including intraoral scanning, CBCT imaging, and virtual planning—was used to design and fabricate a customized CAD/CAM titanium mesh for vertical guided bone regeneration. A mixture of autogenous bone and anorganic bovine bone (A-Oss) was used as graft material. Nine months later, two implants with a hydrophilic SOI surface were placed using a fully guided surgical protocol (OneGuide system). Subsequent soft tissue grafting and prosthetic rehabilitation with monolithic zirconia restorations led to stable and satisfactory functional and aesthetic outcomes. This case demonstrates how modern digital technologies, combined with advanced regenerative techniques and implant surfaces, can significantly improve the predictability and success of implant retreatment in compromised sites.