Implantoplasty and the risk of fracture of narrow implants with advanced bone loss: A laboratory study
Abstract: ObjectivesTo assess the impact of implantoplasty (IP) on maximum implant failure strength of narrow diameter implants of different type/design and material, with simulated advanced bone loss.Materials and MethodsNarrow, parallel‐walled implants (3.3 mm in diameter × 10 mm long) with an internal connection of different type/design [bone level (BL), tissue level (TL)] and material [Titanium grade IV (Ti), Titanium‐Zirconium alloy (TiZr)] from one specific manufacturer were used. Half of the implants were subject… Show more
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Cited by 3 publications
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Ten‐year follow‐up after peri‐implantitis treatment using resective surgery: A case report
BackgroundPeri‐implantitis poses significant challenges in clinical practice, necessitating effective therapeutic strategies. This case report presents a comprehensive treatment approach for managing peri‐implantitis, focusing on resective surgery, including implantoplasty and long‐term maintenance.MethodsWe describe the case of a 50‐year‐old female patient with peri‐implantitis affecting a maxillary full‐arch implant‐supported rehabilitation. The treatment strategy involved resective surgery with implantoplasty, a new maxillary overdenture, and a regular maintenance care schedule of three to four visits per year. Clinical and radiographic assessments were performed over a 10‐year follow‐up period.ResultsPost‐treatment, all maxillary implants demonstrated no probing depths exceeding 4 mm, absence of bleeding on probing or suppuration, minimal plaque accumulation, and no further bone loss. Resective surgery with implantoplasty seems to have effectively provided submucosal decontamination and created a supra‐mucosal implant surface conducive to oral hygiene. Despite regular maintenance, some mandibular implants exhibited bone loss during the follow‐up period and were managed using the same approach as for the maxillary implants.ConclusionsThe comprehensive treatment approach yielded favorable long‐term clinical and radiographic outcomes, underscoring the effectiveness of the combined strategies in managing peri‐implantitis. Nevertheless, the potential for recurrence or the development of peri‐implantitis in new implants, even after a decade of successful treatment and strict maintenance, highlights the importance of ongoing, diligent care and regular evaluations to promptly diagnose and address these issues.Key pointsWhy is this case new information? The long‐term effectiveness of peri‐implantitis treatments, particularly involving implantoplasty, remains under‐documented. This case provides insights from a 10‐year follow‐up on the efficacy of a comprehensive approach for managing peri‐implantitis. Furthermore, these findings illustrate the potential for new peri‐implantitis to develop, regardless of sustained peri‐implant health and rigorous maintenance. This finding highlights the critical role of continuous monitoring for the early diagnosis and treatment of new implants exhibiting peri‐implantitis. What are the keys to the successful management of this case? The success of this case hinged on a comprehensive treatment approach that combines surgical intervention associated with implantoplasty to remove implant threads, thereby creating smoother surfaces, less retentive for plaque accumulation. A critical aspect of this approach was also the redesign of prosthetic components to improve hygiene accessibility, continuous monitoring, and consistent maintenance care. What are the primary limitations to success in this case? The primary challenge in achieving success in this case was the prevention of new implants with peri‐implantitis, despite the patient's consistent adherence to the maintenance program. Moreover, a critical evaluation of implant characteristics, particularly their susceptibility to mechanical failures, is paramount when performing implantoplasty. Furthermore, aligning patient expectations with the realistic esthetic and functional outcomes of the treatment is often challenging. Plain language summaryPeri‐implantitis, an inflammatory disease affecting dental implants, is quite challenging to treat. This case report describes how a 50‐year‐old woman with this condition was successfully treated and maintained over 10 years. The approach included a surgical method called resective surgery, which involved reshaping the bone defect (osteoplasty) and smoothing the implant surface (implantoplasty). Additionally, she was fitted with a new upper denture and had regular follow‐up visits three to four times a year. After ten years, her upper implants were stable with no signs of infection or further bone loss, and they were easy to keep clean. Some of her lower implants did experience inflammation with progressive bone loss during this time, but they were managed using the same surgical procedure as for her upper implants. This 10‐year case report highlights positive and stable clinical results after resective surgery for treating peri‐implantitis and the importance of an interdisciplinary approach and regular check‐ups for maintenance, early diagnosis, and management of peri‐implantitis over the long term.
Ten‐year follow‐up after peri‐implantitis treatment using resective surgery: A case report
BackgroundPeri‐implantitis poses significant challenges in clinical practice, necessitating effective therapeutic strategies. This case report presents a comprehensive treatment approach for managing peri‐implantitis, focusing on resective surgery, including implantoplasty and long‐term maintenance.MethodsWe describe the case of a 50‐year‐old female patient with peri‐implantitis affecting a maxillary full‐arch implant‐supported rehabilitation. The treatment strategy involved resective surgery with implantoplasty, a new maxillary overdenture, and a regular maintenance care schedule of three to four visits per year. Clinical and radiographic assessments were performed over a 10‐year follow‐up period.ResultsPost‐treatment, all maxillary implants demonstrated no probing depths exceeding 4 mm, absence of bleeding on probing or suppuration, minimal plaque accumulation, and no further bone loss. Resective surgery with implantoplasty seems to have effectively provided submucosal decontamination and created a supra‐mucosal implant surface conducive to oral hygiene. Despite regular maintenance, some mandibular implants exhibited bone loss during the follow‐up period and were managed using the same approach as for the maxillary implants.ConclusionsThe comprehensive treatment approach yielded favorable long‐term clinical and radiographic outcomes, underscoring the effectiveness of the combined strategies in managing peri‐implantitis. Nevertheless, the potential for recurrence or the development of peri‐implantitis in new implants, even after a decade of successful treatment and strict maintenance, highlights the importance of ongoing, diligent care and regular evaluations to promptly diagnose and address these issues.Key pointsWhy is this case new information? The long‐term effectiveness of peri‐implantitis treatments, particularly involving implantoplasty, remains under‐documented. This case provides insights from a 10‐year follow‐up on the efficacy of a comprehensive approach for managing peri‐implantitis. Furthermore, these findings illustrate the potential for new peri‐implantitis to develop, regardless of sustained peri‐implant health and rigorous maintenance. This finding highlights the critical role of continuous monitoring for the early diagnosis and treatment of new implants exhibiting peri‐implantitis. What are the keys to the successful management of this case? The success of this case hinged on a comprehensive treatment approach that combines surgical intervention associated with implantoplasty to remove implant threads, thereby creating smoother surfaces, less retentive for plaque accumulation. A critical aspect of this approach was also the redesign of prosthetic components to improve hygiene accessibility, continuous monitoring, and consistent maintenance care. What are the primary limitations to success in this case? The primary challenge in achieving success in this case was the prevention of new implants with peri‐implantitis, despite the patient's consistent adherence to the maintenance program. Moreover, a critical evaluation of implant characteristics, particularly their susceptibility to mechanical failures, is paramount when performing implantoplasty. Furthermore, aligning patient expectations with the realistic esthetic and functional outcomes of the treatment is often challenging. Plain language summaryPeri‐implantitis, an inflammatory disease affecting dental implants, is quite challenging to treat. This case report describes how a 50‐year‐old woman with this condition was successfully treated and maintained over 10 years. The approach included a surgical method called resective surgery, which involved reshaping the bone defect (osteoplasty) and smoothing the implant surface (implantoplasty). Additionally, she was fitted with a new upper denture and had regular follow‐up visits three to four times a year. After ten years, her upper implants were stable with no signs of infection or further bone loss, and they were easy to keep clean. Some of her lower implants did experience inflammation with progressive bone loss during this time, but they were managed using the same surgical procedure as for her upper implants. This 10‐year case report highlights positive and stable clinical results after resective surgery for treating peri‐implantitis and the importance of an interdisciplinary approach and regular check‐ups for maintenance, early diagnosis, and management of peri‐implantitis over the long term.
Reduced Biofilm Accumulation on Implants Treated With Implantoplasty—An In Situ Trial With a Within‐Subject Comparison
ObjectivesThis study aimed to evaluate potential differences in biofilm accumulation on three different implant surfaces: turned surface (TS), modified surface (MS), and modified surface treated with implantoplasty (IPS), using a within‐subject comparison.Material and MethodsTen volunteers wore individualized splints containing three titanium implants with different surfaces (TS, MS, and IPS) on each buccal side of the splint. The implant position (anterior, central, and posterior) was randomly assigned among the three implants on each side. Volunteers were instructed to wear the splint for 72 h and to remove it only for eating, drinking, and performing standard oral hygiene; the splint itself was not cleaned. After 72 h, the implants were carefully removed from the splint, and the accumulated biofilm was assessed using a crystal violet assay by measuring intensity/absorbance at 570 nm.ResultsAll volunteers reported no deviations from the instructions. The lowest mean amount of biofilm (0.405 ± 0.07) was detected on implants of the IPS group, followed by implants of the MS (0.463 ± 0.06) and TS group (0.467 ± 0.07). A multilevel mixed‐effects linear regression analysis confirmed that implants of the IPS group accumulated a significantly lower amount of biofilm than the other surfaces (p < 0.001); however, no significant difference was detected between implants of the TS and MS groups (p = 0.806).ConclusionsImplantoplasty can generate a surface significantly less conducive to biofilm accumulation in the short term compared to pristine implants with turned or modified surfaces.Trial Registration: clinicaltrials.gov identifier: NCT06049121.
Surgical treatment of peri-implantitis
As utilisation of dental implants continues to rise, so does the incidence of biological complications. When peri-implantitis has already caused extensive bone resorption, the dentist faces the dilemma of which therapy is the most appropriate to maintain the implant. Since non-surgical approaches of peri-implantitis have shown limited effectiveness, the present paper describes different surgical treatment modalities, underlining their indications and limitations. The primary goal in the management of peri-implantitis is to decontaminate the surface of the infected implant and to eliminate deep peri-implant pockets. For this purpose, access flap debridement, with or without resective procedures, has shown to be effective in a large number of cases. These surgical treatments, however, may be linked to post-operative recession of the mucosal margin. In addition to disease resolution, reconstructive approaches also seek to regenerate the bone defect and to achieve re-osseointegration.
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