This investigation was designed to evaluate the reestablishment of bone-to-implant contact on infected dental implant surfaces following decontamination with an erbium, chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser and reconstructive therapy. Three patients presenting with at least one failing implant each were enrolled and consented to treatment with the Er,Cr:YSGG laser surface decontamination and reconstruction with a bone replacement allograft and a collagen membrane. The laser treatment was carried out at a setting of 1.5 W, air/water of 40%/50%, and pulse rate of 30 Hz. At 6 months, all three patients returned for the study. En bloc biopsy samples of four implants were obtained and analyzed. Two patients had excellent clinical outcomes, while one patient with two adjacent failing implants experienced an early implant exposure during the follow-up period. There was histologic evidence of new bone formation with two implant specimens and less bone gain with the others. Despite the small sample size, these were optimistic findings that suggested a positive role of Er,Cr:YSGG laser in debridement of a titanium implant surface to facilitate subsequent regenerative treatment. This investigation provides histologic evidence as well as encouraging clinical results that use of the Er,Cr:YSGG laser can be beneficial for treatment of peri-implantitis, but further long-term clinical studies are needed to investigate the treatment outcome obtained.