Inclusion Criteria:  More than 18 years old No periodontal or peri-implant treatment in the last 3 months prior to the study Presence of a minimum of one implant in function more than one year with signs of early and moderate peri-implantitis Prosthetic rehabilitation of the implant with diagnosed peri-implantitis more than 6 months Presence of peri-implant pocket depth more than 4 mm Radiogrpih bone level loss more than 2 mm 7 Positive sign of bleeding on probing with or without suppuration  Exclusion Criteria:  Uncontrolled medical conditions Use of systemic antibiotics in the previous 3 months Use of anti-inflammatory drugs in the previous 6 months