Re‐osseointegration following reconstructive surgical therapy of experimental peri‐implantitis. A pre‐clinical in vivo study

Abstract

Objective To evaluate the effect of bone substitute materials on hard and soft tissue healing in reconstructive surgical therapy of experimental peri‐implantitis at implants with different surface characteristics. Material and methods Six female, Labrador dogs were used. 3 months after tooth extraction, four implants with two different surface characteristics (A and B) were installed on each side of the mandible. Experimental peri‐implantitis was induced 3 months later. During surgical treatment of peri‐implantitis, the implants were cleaned with curettes and cotton pellets soaked in saline. The implant sites were allocated to one of four treatment categories; (a) Group C; no augmentation, (b) Group T1; bone defect filled with deproteinized bovine bone mineral (c) Group T2; bone defect filled with a biphasic bone graft material, (d) Group T3; bone defect filled as T1 and covered with a collagen membrane. Clinical and radiological examinations were performed, and biopsies were obtained and prepared for histological analysis 6 months after peri‐implantitis surgery. Results Implant B (smooth surface) sites showed significantly (a) larger radiographic bone level gain, (b) enhanced resolution of peri‐implantitis lesions, and (c) larger frequency of re‐osseointegration than implant A (moderately rough surface) sites. Implant B sites also showed superior preservation of the mucosal margin. Differences between bone substitute materials and control procedures were overall small with limited advantages for T1 and T2 sites. Conclusion Healing following reconstructive surgical treatment of experimental peri‐implantitis was superior around implants with a smooth surface than implants with a moderately rough surface. Benefits of using bone substitute materials during surgical therapy were overall small.

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

“…(2017) pointed to that implant surface characteristics affected the risk for recurrence/progression. This finding may be explained by the difficulty of decontaminating modified implant surfaces during surgical therapy, as demonstrated in several pre‐clinical studies (Albouy, Abrahamsson, Persson, & Berglundh, 2011; Almohandes, Carcuac, Abrahamsson, Lund, & Berglundh, 2019; Carcuac et al., 2013; Persson, Berglundh, Lindhe, & Sennerby, 2001). Another possible explanation for the increased risk for recurrence of disease at modified implant surfaces may be that such implants are more prone to bacterial recolonization after surgical treatment of peri‐implantitis.…”

Microbial and host‐derived biomarker changes during ligature‐induced and spontaneous peri‐implantitis in the Beagle dog

“…In fact, a histological analysis revealed that the vertical dimensions of the lesion, the pocket epithelium, and the apical extension of the biofilm were larger for micro‐rough surfaces than for turned surfaces 31 . Into the bargain, clinical 37 and preclinical 38 data pointed out that peri‐implantitis resolution in implants with turned surface was more efficient than with micro‐rough surfaces. Notwithstanding, to our best knowledge, this is the first experimental report testing the concept of hybrid implants compared to previous trials that evaluated machined‐surface implants 1,30,31,39 .…”

“…31,36 In fact, a histological analysis revealed that the vertical dimensions of the lesion, the pocket epithelium, and the apical extension of the biofilm were larger for micro-rough surfaces than for turned surfaces. 31 Into the bargain, clinical 37 and preclinical 38 data pointed out that peri-implantitis resolution in implants with turned surface was more efficient than with micro-rough surfaces.…”

Peri-Implantitis Regenerative Therapy: A Review

“…The goal of peri-implantitis treatments is re-osseointegration or bone fill of the osseous defect to provide support to peri-implant soft tissue and thereby improve esthetic outcomes [ 2 , 22 ]; surgical regenerative approaches are indicated to achieve this goal. Nevertheless, these techniques are not always applicable due to varying defect morphologies and progressively advancing stages of the disease.…”

“…Re-osseointegration or regeneration, by definition, is an event that can only be assessed histologically in experimental models [ 2 , 22 ]. The efficacy of peri-implantitis treatment can vary depending on the outcome variables [ 22 ].…”