Effectiveness of enamel matrix derivative on the clinical and microbiological outcomes following surgical regenerative treatment of peri‐implantitis. A randomized controlled trial

Isehed, Catrine; Holmlund, Anders; Renvert, Stefan; Svenson, B; Johansson, Ingegerd; Lundberg, Pernilla

doi:10.1111/jcpe.12583

Cited by 63 publications

(121 citation statements)

References 46 publications

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“…The included studies are described in Tables and . Out of the 16 relevant studies, three included controls and were designed as randomized controlled trials (Isehed et al., ; Jepsen et al., ; Wohlfahrt et al., ). Each study included one single experimental group, and open‐flap debridement was provided to controls.…”

Section: Resultsmentioning

confidence: 99%

“…One study (Jepsen et al., ) included multiple centres, while the remaining investigations were performed at single clinical centres. A formal power calculation was described in six (Aghazadeh et al., ; Isehed et al., ; Jepsen et al., ; Schwarz et al., , ; Wohlfahrt et al., ) of the 16 included studies.…”

Section: Resultsmentioning

confidence: 99%

“…In two of the three controlled studies, porous titanium granules were used in the intervention groups (Jepsen et al., ; Wohlfahrt et al., ), while the third evaluated the potential benefit of enamel matrix derivate (Isehed et al., ).…”

Section: Resultsmentioning

confidence: 99%

“…The assessment of risk of bias in the included randomized trials is illustrated in . A low risk of bias was noted in one study only (Isehed et al., ), based on the apparent difficulty to blind the examiner during radiological assessments in the studies evaluating bone replacement grafts (detection bias). In addition, a substantial patient dropout was noted for the long‐term follow‐up (7 years) for two studies (Andersen, Aass, & Wohlfahrt, ; Schwarz et al., ).…”

Section: Resultsmentioning

confidence: 99%

“…Additional data kindly provided by Isehed et al. (). Not considered: Baseline and/or 12‐month bone levels (mean) not reported: Roccuzzo et al.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of reconstructive surgical therapy at peri‐implantitis‐related bone defects. A systematic review and meta‐analysis

Tomasi

Regidor²,

Ortiz‐Vigón

et al. 2019

J Clinic Periodontology

106

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Objectives The present systematic review aimed at evaluating the efficacy of reconstructive surgical therapy at peri‐implantitis‐related bone defects. Methods Studies reporting on outcomes of reconstructive surgery at peri‐implantitis‐related bone defects at 12 months were identified through an electronic search. Following data extraction, two different sets of meta‐analyses were performed. Primarily, controlled studies were used to evaluate the potential benefit of reconstructive surgical therapy over controls. Secondly, overall outcome of reconstructive surgical therapy was assessed by comparing baseline values with outcomes at 12 months. Results were expressed as weighted mean differences (WMD) or risk ratios (RR). Heterogeneity was described by I2 and prediction intervals. Results The potential benefit of reconstructive techniques over control procedures was evaluated in three studies, representing a total of 116 implants. Altogether, 16 studies reported on the outcome of reconstructive measures at 12 months after surgery. The meta‐analyses identified a larger improvement in marginal bone levels (MBL, WMD = 1.7 mm) and in defect fill (WMD = 57%) for test procedures, but found no differences for clinical measures (reduction of probing depth (PD) and bleeding on probing (BOP). Changes of clinical attachment and soft tissue levels were not considered. In terms of overall outcome, therapy resulted in improved MBL (WMD = 2.0 mm) and CAL (WMD = 1.8 mm), in recession (WMD = 0.7 mm), in reduced PD (WMD = 2.8 mm) and in reduced BOP (Implants: RR = 0.4/Sites: RR = 0.2). None of the included studies addressed patient‐reported outcome measures. Conclusions The available evidence on reconstructive therapy at peri‐implantitis‐related defects is limited by (a) the low number of controlled studies, (b) the lack of controlled studies for commonly used procedures, (c) the heterogeneity between studies and (d) the choice of outcome measures. A high variability for predicted outcomes at 12 months was noted. The interpretation of the demonstrated larger MBL gain for test procedures is difficult as graft material may not be distinguishable from newly formed bone. Potential aesthetic and patient‐reported advantages remain to be demonstrated.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Additional data kindly provided by Isehed et al. (). Not considered: Baseline and/or 12‐month bone levels (mean) not reported: Roccuzzo et al.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of reconstructive surgical therapy at peri‐implantitis‐related bone defects. A systematic review and meta‐analysis

Tomasi

Regidor²,

Ortiz‐Vigón

et al. 2019

J Clinic Periodontology

106

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Surgical Treatment of Peri‐implantitis

Romanos

2024

Saving Dental Implants

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Repeated delivery of chlorhexidine chips for the treatment of peri‐implantitis: A multicenter, randomized, comparative clinical trial

Machtei

Romanos

Kang

et al. 2020

Journal of Periodontology

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Background Peri‐implantitis is a challenging condition to manage and is frequently treated using non‐surgical debridement. The local delivery of antimicrobial agents has demonstrated benefit in mild to moderate cases of peri‐implantitis. This study compared the safety and efficacy of chlorhexidine gluconate 2.5 mg chip (CHX chips) as an adjunctive treatment to subgingival debridement in patients afflicted with peri‐implantitis. Methods A multicenter, randomized, single‐blind, two‐arm, parallel Phase‐3 study was conducted. Peri‐implantitis patients with implant pocket depths (IPD) of 5‐8 mm underwent subgingival implant surface debridement followed by repeated bi‐weekly supragingival plaque removal and chlorhexidine chips application (ChxC group) for 12 weeks, or similar therapy but without application of ChxC (control group). All patients were followed for 24 weeks. Plaque and gingival indices were measured at every visit whereas IPD, recession, and bleeding on probing were assessed at 8, 12, 16, 24 week. Results A total of 290 patients were included: 146 in the ChxC group and 144 in the control. At 24 weeks, a significant reduction in IPD (P = 0.01) was measured in the ChxC group (1.76 ± 1.13 mm) compared with the control group (1.54 ± 1.13 mm). IPD reduction of ≥2 mm was found in 59% and 47.2% of the implants in the ChxC and control groups, respectively (P = 0.03). Changes in gingival recession (0.29 ± 0.68 mm versus 0.15 ± 0.55 mm, P = 0.015) and relative attachment gain (1.47 ± 1.32 mm and 1.39 ± 1.27 mm, P = 0.0017) were significantly larger in the ChxC group. Patients in the ChxC group that were < 65 years exhibited significantly better responses (P < 0.02); likewise, non‐smokers had similarly better response (P < 0.02). Both protocols were well tolerated, and no severe treatment‐related adverse events were recorded throughout the study. Conclusions Patients with peri‐implantitis that were treated with an intensive treatment protocol of bi‐weekly supragingival plaque removal and local application of chlorhexidine chips had greater mean IPD reduction and greater percentile of sites with IPD reduction of ≥2 mm as compared with bi‐weekly supra‐gingival plaque removal.

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Effectiveness of enamel matrix derivative on the clinical and microbiological outcomes following surgical regenerative treatment of peri‐implantitis. A randomized controlled trial

Abstract: Adjunctive EMD to surgical treatment of peri-implantitis was associated with prevalence of Gram+/aerobic bacteria during the follow-up period and increased marginal BL 12 months after treatment.

Cited by 63 publications

References 46 publications

Efficacy of reconstructive surgical therapy at peri‐implantitis‐related bone defects. A systematic review and meta‐analysis

Efficacy of reconstructive surgical therapy at peri‐implantitis‐related bone defects. A systematic review and meta‐analysis

Surgical Treatment of Peri‐implantitis

Repeated delivery of chlorhexidine chips for the treatment of peri‐implantitis: A multicenter, randomized, comparative clinical trial

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