A prospective case series on surgical treatment of circumferential and semi-circumferential defects due to peri-implantitis

Abstract

A prospective case series on surgical treatment of circumferential and semi-circumferential defects due to peri-implantitis Abstract: Different surgical treatment strategies for peri-implantitis with the use of graft material and membranes have been suggested without any longitudinal remarkable success rate. The present preliminary study was aimed to analyze a new clinical approach based on the disinfection of the implant connection, the disinfection of the implant surface and GBR approach in the treatment of circumferential and semi-circumferential bony defect resulting from peri-implantitis. Six consecutive patients were selected for the present study. After removal of factors that could potentially influence peri-implant pathology, the prosthetic rehabilitation was always removed and a full thickness flap was elevated to allow access to the peri-implant defect and the exposed implant surface. Once the defect was degranulated and the implant surface cleaned, a mixture (50:50) of autogenous bone and allograft was used. Guided bone regeneration technique using membranes was adopted and the flaps were closed for a submerged healing. Six months thereafter, a new reopening procedure was performed and cleaned superstructures and crowns were repositioned. Patients were followed for one year thereafter and recalled for a customized oral hygiene every three months. Radiological and periodontal analysis was performed before surgery and every six months. The studied procedure was associated with a pronounced increase in REC and CAL with stable peri-implant conditions at 6 and 12 months. PI, BOP and PD values were significantly reduced both at 6 and 12 months. At 12 months, a mean PD gain of 4.5 mm and a bone loss reduction of 5.1 mm was obtained. Within the limitation of the present preliminary study, the proposed technique might represent a promising result for treatment of circumferential and semi-circumferential bone defects around implants affected by peri-implantitis.

Disinfection and Biocompatibility of Titanium Surfaces Treated with Glycine Powder Airflow and Triple Antibiotic Mixture: An In Vitro Study

“…Peri-implantitis (PI), also known as implant infection, is a biological complication involving soft and hard tissues around the osseointegrated implants [ 5 , 6 ]. It consists of a polymicrobial anaerobic infection which causes a chronic inflammatory process [ 5 , 7 ], leading to the formation of a peri-implant pocket with consequent bone loss [ 8 , 9 ]. PI prevalence has been recently estimated to be involved in more than 12% of the implant treatments in the clinical practice [ 10 , 11 ].…”

Latest Findings of the Regenerative Materials Application in Periodontal and Peri-Implant Surgery: A Scoping Review

“…The studies were from four categories: controlled intervention studies [ 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ], observational cohort and cross-sectional studies [ 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ], and case series/case reports studies [ 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ].…”

Influence of Removing or Leaving the Prosthesis after Regenerative Surgery in Peri-Implant Defects: Retrospective Study: 32 Clinical Cases with 2 to 8 Years of Follow-Up

“…No conclusions could be drawn due to the high heterogeneity between the current studies. Canullo et al [21] deduced in a prospective study that they obtained better results when the prosthetic restoration was removed. Daugela et al [35] reported no statistically significant differences between removing the prosthesis or not during the healing process.…”

“…Recent meta-analyses, such as that of Lollobrigida et al [34], revealed that there are only two studies [21,35] that compare the effect of healing in peri-implant defects, removing prosthetic restorations or not after regenerative surgery in peri-implantitis, showing better clinical results when submerged healing and barrier membranes were performed, and furthermore indicating that rough surfaces can improve reosseointegration when compared to smooth surfaces. This confirms what is described by Schwarz et al [29], who found that submerged healing is preferable for several reasons, since there is complete isolation in the regenerated area, better soft tissue healing, and a decrease in the risk of postoperative infection.…”

“…The main objective of this study is to determine the influence on the healing process of leaving or not leaving the prosthesis after regenerative surgical treatment of bone defects produced by peri-implant pathology [19][20][21].…”