Evidence of re-osseointegration after electrolytic cleaning and regenerative therapy of peri-implantitis in humans: a case report with four implants

Bosshardt, Dieter D.; Brodbeck, Urs; Rathe, Florian; Stumpf, Thomas; Imber, Jean‐Claude; Weigl, Paul; Schlee, Markus

doi:10.1007/s00784-021-04345-1

Cited by 10 publications

(8 citation statements)

References 21 publications

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“…The regenerative therapy of peri‐implantitis deficiencies using this electrolytic approach led to reduced PPD, BOP, suppuration, and a significant RDF of about 3 mm after a follow‐up of 18 months 57 . Evidence of re‐osseointegration followed by electrolytic therapy was also observed later in a histologic examination in humans 70 …”

Section: Resultsmentioning

confidence: 86%

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Bone regeneration as treatment of peri‐implant disease: A narrative review

Noelken

2023

Clin Implant Dent Rel Res

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Introduction Analysis of the 3‐dimensional implant position, the bone defect morphology, and the soft tissue situation guides the decision to preserve or to remove an implant with a severe peri‐implantitis lesion. The aim of this narrative review was to analyze and to comprehensively illustrate the treatment options focusing on peri‐implant bone regeneration in presence of severe peri‐implant bone loss. Methods A database search was performed independently by the two reviewers to identify case reports, case series, cohort, retrospective, and prospective studies about peri‐implant bone regeneration with a follow‐up of at least 6 months. Of the 344 studies issued during the database analysis, 96 publications were selected by the authors for this review. Results Deproteinized bovine bone mineral remains the best documented material for defect regeneration in peri‐implantitis in combination with or without a barrier membrane. While studies using autogenous bone in peri‐implantitis therapy are rarely found, they do report favorable potential of vertical bone regeneration. Moreover, while membranes are an inherent part of the guided bone regeneration, a 5‐year follow‐up study demonstrated clinical and radiographic improvements with and without a membrane. The administration of systemic antibiotics is frequently performed in clinical studies observing regenerative surgical peri‐implantitis therapy, but the analysis of the literature does not support a positive effect of this medication. Most studies for regenerative peri‐implantitis surgery recommend the removal of the prosthetic rehabilitation and the use a marginal incision with a full‐thickness access flap elevation. This allows for a good overview for regenerative procedures with a certain risk of wound dehiscences and incomplete regeneration. An alternative approach referring to the poncho technique may reduce the risk of dehiscence. The effectiveness of implant surface decontamination might have an impact on peri‐implant bone regeneration without any clinical superiority of a certain technique. Conclusion The available literature reveals that the success of peri‐implantitis therapy is limited to the reduction of bleeding on probing, the improvement of the peri‐implant probing depth and a small amount of vertical defect fill. On this basis, no specific recommendations for bone regeneration in surgical peri‐implantitis therapy can be made. Innovative approaches for flap design, surface decontamination, bone defect grafting material, and soft tissue augmentation should be followed closely to find advanced techniques for favorable peri‐implant bone augmentation.

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Section: Resultsmentioning

confidence: 86%

“…57 Evidence of re-osseointegration followed by electrolytic therapy was also observed later in a histologic examination in humans. 70…”

Section: Electrolytic Approach For Surface Decontaminationmentioning

confidence: 99%

Bone regeneration as treatment of peri‐implant disease: A narrative review

Noelken

2023

Clin Implant Dent Rel Res

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“…Patients with a MBL >5 mm, signs of progressive periodontitis as suppuration, were treated with electrolytic cleaning as described elsewhere (Bosshardt et al, 2022; Schlee et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

Long‐term results in three‐dimensional, complex bone augmentation procedures with customized titanium meshes

Hartmann

Hildebrandt

Younan

et al. 2022

Clinical Oral Implants Res

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Objectives: Complex, three-dimensional bony defects still represent challenging situations in routine implant dentistry. The aim of this study was to evaluate implant survival in customized bone regeneration using a patient-specific titanium mesh.Material and Methods: Patients (n = 21, implants 36) who had obtained an augmentation procedure with patient-specific titanium mesh were examined after 5.7 ± 0.38 years. Survival rate, clinical parameters for periimplantitis (Bleeding on Probing [BOP] and suppuration), and radiographic examination were evaluated. Periimplant marginal bone loss (MBL) was calculated by using an image assessment program. Additionally, the influence of various factors on treatment outcomes such as periodontitis, smoking, professional maintenance, or diabetes was assessed as well as the impact on quality of life applying the Oral Health Impact Profile (OHIP). Results:The implant survival rate was 97%, with one implant loss in the lower jaw.At the end of the observation period, MBL showed mesial 0.13 ± 1.84 mm and distal −0.13 ± 1.73 mm. The lower jaw showed significant more MBL mesial compared with the upper jaw (p = .034, cluster-adjusted). Periodontitis was significantly associated with MBL mesial and distal (p < .05). Positive BOP (four implants) was significantly associated with MBL mesial (p = .0031) and distal (p = .0018). MBL was significantly associated with suppuration mesial (p < .0001) and distal (p < .0001).Conclusions: CBR® results in high implant survival rate and stabilized augmented marginal bone after follow-up of minimum 5 years. Periodontitis seems to play the mayor role for long-term stability indicated by BOP and suppuration.

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“…Surface roughness and thread design of the implants increase osseointegration but are disadvantageous when they are exposed and in need of removal of the adhered plaque and biofilm. Numerous tools for mechanical and electrolytic debridement procedures of the implant surface (scalers, glycine powder, titanium rotary brush, electrolytic procedure, laser) are available and successful [9][10][11][34][35][36][37]. Since the surgical access to the peri-implant lesion is more delicate with the presented LAPIDER technique, only a few instruments are possible to use with this approach which allows to leave the prosthetic restoration in place.…”

Section: Discussionmentioning

confidence: 99%

Hard and soft tissue regeneration of severe peri-implantitis defects with the laser-assisted peri-implant defect regeneration technique: 3-year results

et al. 2023

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Purpose This retrospective cohort study evaluates the regeneration of severe peri-implantitis deficiencies treated with the laser-assisted peri-implant defect regeneration (LAPIDER) approach within a 3-year follow-up. Methods Twenty-four implants with severe peri-implantitis in 18 patients were treated according to the LAPIDER technique. In contrast to classic techniques for reconstructive peri-implantitis surgery with a marginal incision, a buccal split-flap preparation avoiding papillae separation was used. After a coronal flap elevation and a laser-assisted peri-implant defect cleaning, connective tissue and autogenous bone grafting was performed. Primary outcomes were the changes of the marginal bone levels (MBL) and the buccal bone thickness. Secondary outcomes included implant survival, peri-implant probing depths (PPD), bleeding on probing (BOP), recession, width of keratinized mucosa (KMW), thickness of keratinized mucosa (KMT), soft tissue esthetics (PES), and implant success. Results MBL improved interproximal by 3.10 ± 2.02 mm (p < 0.001), buccal by 3.49 ± 2.89 mm (p < 0.001), and lingual by 1.46 ± 1.98 mm (p = 0.003); buccal bone thickness by 0.55 ± 0.60 mm (p = 0.005), and 1.01 ± 1.25 mm (p = 0.001) at 1 and 3 mm below reference level. Two implants were removed; 22 implants were still in function at a mean follow-up of 36 months. PPD changed from 5.05 ± 1.39 to 3.08 ± 0.71 mm (p < 0.001); recession was reduced from 2.07 ± 1.70 to 0.91 ± 1.13 mm (p = 0.001); KMW increased from 2.91 ± 1.81 to 4.18 ± 1.67 mm (p = 0.006); KMT improved from 1.73 ± 0.50 to 2.44 ± 0.43 mm (p < 0.001); PES changed from 7.7 ± 2.8 to 10.7 ± 1.9 (p < 0.001). 45.8% to 54.2% of the implants met the criteria of implant success. Conclusions The favorable results document the proof of principle for the regeneration of severe peri-implant hard and soft tissue deficiencies by the LAPIDER treatment approach.

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Evidence of re-osseointegration after electrolytic cleaning and regenerative therapy of peri-implantitis in humans: a case report with four implants

Cited by 10 publications

References 21 publications

Bone regeneration as treatment of peri‐implant disease: A narrative review

Bone regeneration as treatment of peri‐implant disease: A narrative review

Long‐term results in three‐dimensional, complex bone augmentation procedures with customized titanium meshes

Hard and soft tissue regeneration of severe peri-implantitis defects with the laser-assisted peri-implant defect regeneration technique: 3-year results

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