Yesterday I did a first round of periolase on a patient who has has 2 implant supported bridges in the posterior on this side. I tried to keep total joules to less than 100 around each implant. The areas probed from 4-10 mm with pus coming out on probing. I kind of stirred around the implants with pass one and two and used ultrasonics a bit to clean out a bit also. I noticed some black stuff coming out of the sites and didn't know if it was the implant coating or subgingival calculus. It was not chunks but very fine grain and uniform. Does calc grow on implants? I couldn't remember if there were any specific settings that were to be applied, so I stayed with the standard ones except I had bumped the power to 200 mj for pass one.  He is coming in next week to do the other side and it has a posterior implant bridge also with similar peri-implantitis. Any suggestions? I told him that we may have to address these areas again. What have others found to be the response with this type of situation?

Phil