Bone Loss around Dental Implant: Options?

Try and find a practitioner that has a Waterlase. They have a procedure that is relatively non-invasive for addressing this type of bone loss or peri-implantitis.

Prognosis is poor...perhaps try laser treatment but given the history of all your problems and the current amount of bone loss I would not wait too long to have implant removed before you harm the adjacent teeth

The best option at this point, is to remove the implant. Not only are you losing bone around the implant, it is creating a systemic problem for you as well due to the Inflammatory products traveling through your bloodstream. This is not a situation where another bone graft should be placed around the implant!

The radiographs are from different angle. A clinical exam will determine if there is a pocket/periimplantitis present. Also, I would recommend a vertical bite wing to determine the bone level.

I agree on smDDS, , need clinical examination, and probing carefully for pocketing and presence of periimplantitis & bite wing X-ray , and also, details of patient medical history. another point pt has history of one failure ,need to know the reason of failure and also to exclude any parafunctional habits, then plan treatment of the cause of bone resorption or re-treatment to remove the implant with bone graft period of healing with out implant insertion , . Alan Amin BDS,ADC,FRACDS,PGD/OS, UMFID

Sorry I missed the word comment ,when I said I agree on comment of smDDS

Thanks everyone. Found more photos. One is 2014 after graft and original insertion second is 2016, already loss of bone.  

If there remains signs of inflammation and bone loss after non surgical intervention, see a periodontist. Most of us have a protocol for treating peri-implantitis.

STOOOOP, look at https://www.lanap.com I am treating these cases exclusively with laser irrespective of type. I recommend iLase it is the most unexpensive and mobile wireless. I have the biolase epicX and works excellent I am treating many cases up to now I have solved at least ten periimplantitis cases with lapip kind protocol and it is simple and super predictible. I even place a crown now on a molar near two bicuspids heavily affected which I healed with laser. It is like covid if you fear you wear all measures of protection , if you are informed you just have a gargarism with concentrated saline solution and you can eever possibly give rise to viral concentration in your farinx. If you need more advice find me on 'dental line marius borcoman' on fbook cheers

As you have noted you have minor inflammation and bleeding. That is because this is not periimplantitis it is bone graft failure. The failed cadaver graft is obvious with graft material floating in granulation tissue. The implant cannot be repaired because the graft material will just continue to breakdown. If you want a successful implant in this area when the implant is removed all of the sclerotic bone produced by the cadaver graft will also need to be removed. Becasue very few dentists even know what sclerotic bone is I advise a bridge.