Successful Management of Peri-Implantitis around Short and Ultrashort Single-Crown Implants: A Case Series with a 3-Year Follow-Up

Abstract

Introduction and Aim. In case of peri-implantitis, resective surgery is contraindicated for short and ultrashort implants, limiting the treatment options to regenerative surgery or to implant removal. This retrospective case series presents the clinical and radiographic outcomes of a surgical regenerative procedure to treat peri-implantitis around short and ultrashort implants. Materials and Methods. The study is a retrospective evaluation of patients suffering from peri-implantitis and those who underwent access flap surgery, concomitant chemical and mechanical decontamination of implant surface, and bone grafting using a self-hardening mixture of bone substitutes and biphasic calcium sulfate. No membranes were applied to cover the grafting material, and primary tension-free closure was achieved. The retrospective protocol was reviewed and approved by the Ethics Committee for Clinical Sperimentation (CESC) of Verona and Rovigo, Italy (based in the University of Verona) (Prog. 1863CESC. Date of approval: 2018-07-04). Results. 15 patients (17 implants) have been diagnosed with peri-implantitis after a mean follow-up of 24 months after loading. Implant length was between 5 and 8 mm. 8 patients (10 implants) had a history of periodontitis. At baseline, the mean PD (probing pocket dept) at the deepest site was 8.12 mm, with an average mBI (modified bleeding index) of 2.35 and a mean BD (bone defect depth) of 3.04 mm. At the 3-year follow-up, the CSR was 100%, the mean mBI was 0.88 (average reduction: −1.47), the mean PD was 3.35 mm (mean PD reduction: 4.77 mm), and the mean bone defect was reduced by 1.74 mm, with a mean bone fill of 55%. Conclusions. The results of the present case series suggest that if accurate surface decontamination is achieved, high survival rate and good clinical and radiographic results can be obtained after 3 years. However, only the histological examination could confirm the growth of new bone in direct contact with the implant surface or if the grafted material only fills the space left by the peri-implant defect.

Stresses in lithium disilicate crowns and zirconia implants in patients with bruxism: An in silico study

“…On the same group, the maximum principal stress was concentrated in the bone near the implant cervical area above the first thread. In other words, in the crown-implant, where the most fragile assembly area is found (Lombardo et al, 2019;Bergamo et al, 2021). Concerning the implant, this stress was concentrated in its apical area and the minimum principal stress on this groups was concentrated in the alveolar bone crest and on the apical bone region due to the compression stress.…”

Five-Year Follow-Up of 8 and 6 mm Locking-Taper Implants Treated with a Reconstructive Surgical Protocol for Peri-Implantitis: A Retrospective Evaluation

“…All procedures accorded with the Helsinki Declaration and good clinical practice guidelines for research on human beings. A retrospective evaluation was conducted in a time interval between January and October 2022: patients enrolled for the study had been consecutively referred and treated in 2017 for peri-implantitis on standard, short, and ultra-short locking-taper implants [2,12,40] at the Dental and Maxillo-Facial Surgery University Clinic, and data with 5-year follow-up from the reconstructive treatment were collected. The implant affected by peri-implantitis and consequently treated with reconstructive surgical therapy had to present the following features at the pre-surgical assessment [28]: prosthetic rehabilitation with single crown supporting the implant and without mobility; PPD (peri-implant probing depth) ≥ 5 mm, together with positive BOP (bleeding on probing) and/or suppuration, at least at one of the six probed sites; marginal bone loss > 1 mm visible on radiographic examination at least at the mesial or distal site [12]; patient rejecting the option of implant extraction and consequent post-surgical procedures for implant replacement.…”

“…Exclusion criteria were as previously described [2,12], plus the following: previous peri-implant surgical interventions; allergy to sulfonates and its derivatives; low-sodium diet, kidney diseases, and sodium bicarbonate flavor intolerance [40].…”

“…All surgical treatments were conducted by a single clinician, as previously described [40]. A complete clinical and radiographic evaluation (dental and periodontal status; panoramic and periapical radiograph; cone beam computed tomography) and basic periodontal treatment were performed before surgery.…”

Survival rates of ultra‐short (<6 mm) compared with short locking‐taper implants supporting single crowns in posterior areas: A 5‐year retrospective study

“…During the time interval from loading to follow-up, 28 implants experienced loss of supporting bone >1 mm: 19 of them (67.85%) were surgically treated with a codified protocol, which consisted in access flap surgery, concomitant chemical and mechanical decontamination (through the application of a desiccant agent and sodium bicarbonate-based abrasive air powder) of implant surface and bone grafting 45. Out of 19 implants, peri-implantitis was thus successfully treated in 9 implants (47.36%), which demonstrated bone levels stability at the 5-year follow-up.…”