Porous titanium granules in the treatment of peri-implant osseous defects—a 7-year follow-up study

Abstract

BackgroundA great number of different treatment protocols for peri-implantitis have been suggested but there is no consensus regarding the most effective intervention. The aim of the present study was to evaluate the long-term clinical and radiographic results from a study on peri-implant osseous defect reconstruction.Patients having participated in a randomized clinical study 7 years earlier were invited for a re-examination. The treatment procedures included open flap debridement (OFD) with or without defect reconstruction with porous titanium granules (PTGs). Clinical parameters (probing pocket depth and bleeding on probing) and radiographic measurements were registered.FindingsOf the original 32 patients, 12 patients with 12 implants were finally examined after 7 years (7.3 years [6.7–8]). Patients had been maintained one to two times yearly. The PTG group showed a mean probing pocket depth of 4.3 mm ± 2.4 compared with 3.5 mm ± 1.2 in the OFD group, at the deepest site. The change between the 12 months and the 7-year examination was similar in both groups.Five of the test implants and five of the control implants had at least one site with positive bleeding on probing score.The mean radiographic defect depth change as compared to 12 months was an increase of 1.9 mm ± 2.0 in the PTG group and a mean radiographic defect depth increase of 1.3 mm ± 1.4 in the OFD group.Due to the small number of patients, a statistical analysis was not performed, but the results indicated a minimal difference in osseous defect depth as compared with baseline and between groups.No PTG exposed to the oral cavity was observed, but the graft particles were seemingly scattered in the peri-implant soft tissue.ConclusionsThis long-term follow-up of surgical treatment of peri-implant osseous defects showed unpredictable results.

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

“…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., ). This, however, was not relevant for outcomes at 12 months.…”

“…None of the studies with controls reported on changes of CAL, REC or PROMs. Implant survival over at least 5 years was described in one of the interventional studies (Andersen et al., ). Over a 7‐year follow‐up, 3 of 17 implants were lost in three patients, all belonging to the test group (porous titanium granules).…”

Risk for recurrence of disease following surgical therapy of peri‐implantitis—A prospective longitudinal study

“…Available data are either based on retrospective assessments (Berglundh, Wennström, & Lindhe, 2018) or on samples of limited size (Andersen, Aass, & Wohlfahrt, 2017; Heitz‐Mayfield et al., 2018; Roccuzzo, Pittoni, Roccuzzo, Charrier, & Dalmasso, 2017; Schwarz, John, Schmucker, Sahm, & Becker, 2017). In these reports, different treatment protocols were evaluated, including open‐flap debridement (Heitz‐Mayfield et al., 2018), pocket elimination/reduction (Berglundh et al., 2018; Serino, Turri, & Lang, 2015), and reconstructive approaches (Andersen et al., 2017; Roccuzzo et al., 2017; Roos‐Jansåker, Persson, Lindahl, & Renvert, 2014; Schwarz et al., 2017). While data from all studies indicated that disease progression could be suppressed in the long‐term, a subgroup of implant sites displayed recurrence/progression of peri‐implantitis after treatment.…”

“…Information on long-term outcomes following surgical therapy of peri-implantitis is limited. Available data are either based on retrospective assessments (Berglundh, Wennström, & Lindhe, 2018) or on samples of limited size (Andersen, Aass, & Wohlfahrt, 2017;Heitz-Mayfield et al, 2018;Roccuzzo, Pittoni, Roccuzzo, Charrier, & Dalmasso, 2017;Schwarz, John, Schmucker, Sahm, & Becker, 2017).…”

Reconstructive surgical therapy of peri-implantitis bone defects

“…In this study, the primary outcome was the radiographic bone filling and although it is true that statistically significant differences were found in favor of the test group, it is necessary to admit the difficulty of distinguishing the biomaterial at the radiographic level. However, other studies describe contradictory results regarding the use of this biomaterial (22,23).…”