Implantoplasty involves mechanically modifying the exposed implant surface by removing macro- and micro-structures and is typically considered a resective approach. The potential for bone regeneration with implantoplasty alone has not yet been studied. This research aimed to evaluate long-term changes in peri-implant bone levels without using regenerative materials. 56 patients (70 implants) were included in the study and were followed for up to 10 years, with a mean observation time of 59 months (~5 years). The implants were evaluated retrospectively through a radiographic, as well as clinical (bleeding on probing and suppuration) analysis. Out of the 70 implants, 11 (15.7%) were lost due to disease recurrence and additional bone loss. One implant (1.4%) experienced up to 1.0 mm of bone loss, 15 implants (21.4%) showed no change in marginal bone levels (MBL), and 43 implants (61.5%) gained bone up to 4.8 mm, all without the use of any graft material or membrane. The overall mean MBL change for the remaining 59 implants at the end of the follow-up period (84.3%) was a gain of 1.27 mm. Implantoplasty alone without osseous surgery, flap repositioning, or using graft material or membrane; may be a viable option for managing peri-implantitis defects. However, future randomized clinical trials with larger sample sizes are necessary to validate current findings.