Surgical treatment of peri‐implantitis defects with two different xenograft granules: A randomized clinical pilot study

Abstract

Objectives To investigate whether xenograft EB (EndoBon) is non‐inferior to xenograft BO (Bio‐Oss) when used in reconstructive surgery of peri‐implant osseous defects. Materials and methods Dental patients with one implant each demonstrating peri‐implantitis were randomized to receive surgical debridement and defect fill with either BO or EB. Changes in bone level (BL) and intrabony defect depth (IDD) evaluated radiographically were the primary outcomes. The secondary outcomes included changes in probing pocket depth (PPD), bleeding on probing (BoP), and suppuration on probing (SoP). All outcomes were recorded before treatment and at 6 and 12 months post‐treatment. Results Twenty‐four patients (n = 11 BO, n = 13 EB) completed the study. Both groups demonstrated significant within‐group improvements in all clinical and radiographic parameters at 6 and 12 months (p ≤ .001). At 12 months, both groups presented with IDD reductions of 2.5–3.0 mm on average. The inter‐group differences were not statistically significant at all time points and for all the examined parameters (p > .05). While the radiographic defect fill in both groups exceeded > 1 mm and can be considered treatment success, successful treatment outcomes as defined by Consensus Reporting (no further bone loss, PPD ≤ 5 mm, no BOP, and no SoP) were identified in 2/11 (18%) BO and 0/13 (0%) EB individuals (Fisher's exact test, p = .199). Conclusions Within the limitations of this pilot study, the application of xenograft EB showed to be non‐inferior to xenograft BO when used in reconstructive surgery of peri‐implant osseous defects.

Efficacy of alternative or adjunctive measures to conventional non-surgical and surgical treatment of peri-implant mucositis and peri-implantitis: a systematic review and meta-analysis

“…Increased RDF and higher BOP reduction were detected at implants treated with porous titanium granules compared with xenograft, whereas PD reduction and clinical attachment changes did not differ between the treatment groups [ 88 ]. The comparison of the 2 xenograft materials over a 12-month period led to similar treatment outcomes as depicted by similar changes in the BOP, PD, and RDF values, as well as the treatment success (defined as PD ≤ 5 mm + no BOP/SUPP + no further bone loss) [ 86 ].…”

“…Reconstruction of the defect with different bone fillers, with and without a membrane (4 RCTs (5 publications) [82][83][84][85][86] and 3 CCTs (5 publications) [87][88][89][90][91].…”

“…Ten RCTs (12 publications) reported on the non-reconstructive surgical treatment of peri-implantitis [18,[61][62][63][64][65][66][67][71][72][73][74] and 9 studies (13 publications) reported on the surgical treatment of peri-implantitis employing adjunctive reconstructive measures (4 CCTs [69, 87-91], 5 RCTs [68,[82][83][84][85][86]92]). The remaining 6 RCTs (7 publications) compared reconstructive peri-implantitis treatment over non-reconstructive approach [75-81, 93] and 2 RCTs (5 publications) reported on combined periimplantitis therapy (i.e., implantoplasty + reconstructive therapy) (2 RCTs (5 publications) [19,70,[94][95][96]) (Table 3).…”

Efficacy of concentrated growth factor versus collagen membrane in reconstructive surgical therapy of peri-implantitis: 3-year results of a randomized clinical trial

“…The materials and combinations of materials would present better outcomes by means of reconstructive surgical approaches that have also been widely debated. To the present date, many studies in which bovine-derived xenografts with or without a barrier membrane were used for the reconstruction of peri-implant bone defects exhibited a PD reduction range of 1.7–3.8 mm [ 11 , 13 , 25 – 28 ] and radiographic vertical defect reduction range of 0.7–3.0 mm [ 11 , 25 , 27 – 29 ] at year 1 postoperatively. The discrepancies regarding clinical and radiographic outcomes might probably be explained by using or not using a barrier membrane or another biological agent, different baseline bone defects characteristics, different implant surface characteristics, and using different implant surface decontamination methods.…”

Comparison of Injectable Biphasic Calcium Phosphate and a Bovine Xenograft in Socket Preservation: Qualitative and Quantitative Histologic Study in Humans

“…Due to their good mechanical properties and resorption strength, xenografts are often used in combination with autogenous bone to achieve better volume stability of the augmented area [ 20 ]. They are available in various forms, most commonly as granules that need to be mixed with saline or blood before use, or as prefabricated blocks that are attached to the defect site with pins [ 21 , 22 ].…”