This patient presented with purulence and 9+mm probing along the facial of an otherwise integrated implant placed some 3-4 years ago. I treatment planned the patient for a connective tissue graft as it is my belief that soft tissue health is the key to long term stability and I do not believe that GBR around an existing implant is predictable enough to tout it as a solution. In this case I debrided the defect and cleansed the exposed threads with a sulca brush and copious irrigation. Because I wanted a foundation, or extra bulk under the connective tissue, I placed an HA graft within the defect before laying the tissue in place. My reason for choosing HA over some other material is simply that I had some on the shelf and anything will suffice as the goal is just to provide some additional support for the connective tissue… so whatever is your graft material of choice would be my suggestion.
I did not place or restore this fixture so any mention of the alignment or the facial access hole is not of my doing and I can not comment on it