A prospective case series was performed to examine the clinical and radiographic changes to peri-implant tissues 2 years after resective treatment of peri-implantitis, including an apically positioned flap, osteoplasty, and implantoplasty. In total, 25 patients with 40 titanium implants of multiple brands and advanced peri-implantitis were included in this study. After 2 years, all implants survived, mean probing pocket depth was reduced from 8.7 to 3.3 mm, and bone level remained stable in 92.5% of the implants. Findings suggest the approach of an apically positioned flap combined with osteoplasty and implantoplasty as an effective and reliable strategy against peri-implantitis, although increased gingival recessions may limit its application in esthetic areas.