Immediate Reimplantation Protocol (iRIP): Case Report and Proof of Principle.

This case highlights the immediate reimplantation protocol (iRIP), a novel approach to managing a failing implant in the maxillary posterior region, emphasizing the simultaneous approach of implant removal, immediate implant placement, and bone reconstruction by guided bone regeneration. A 39-year-old man presented with a failing implant at position 15 (FDI numbering system) due to peri-implantitis, characterized by bleeding on probing, suppuration, and inflammation, with probing pocket depths of up to 9 mm. Radiographic assessment revealed significant peri-implant bone loss, with only 4 mm of residual osseointegration. Presurgical 3D planning ensured precise implant positioning, avoiding sinus perforation and optimizing stability. During surgery, the failing implant was removed using minimally traumatic techniques, and a new tissue-level implant was immediately placed, achieving a primary stability torque of 27 Ncm. The circumferential bone defect was treated with deproteinized bovine bone mineral combined with hyaluronic acid and covered with a resorbable collagen membrane to initiate bone reconstruction. The implant site was submerged, and healing was uneventful. At 3 months postsurgery, the implant was uncovered, and a screwretained monolithic zirconia crown was placed, restoring masticatory function and esthetics. At the 12-month follow-up, the patient presented a healthy implant site and no remaining bone defect. The approach achieved successful osseointegration, significant clinical and radiographic improvements, and stability after 12 months. This case highlights the potential of a protocol achieving immediate resolution of peri-implantitis by the use of a new sterile implant.