Treatment of peri‐implantitis with a flapless surgical access combined with implant surface decontamination and adjunctive systemic antibiotics: A retrospective case series study

Abstract

AimTo evaluate the effectiveness of a flapless surgical approach in the treatment of peri‐implantitis and to explore the factors influencing its outcome.Materials and MethodsThe present retrospective study evaluated patients with at least one implant diagnosed with peri‐implantitis and treated with a flapless surgical access, with or without systemic antimicrobials, curettage and, when needed, prostheses modification. Clinical and radiographic parameters were assessed at baseline and at 3 months and at least 12 months. The primary outcome was disease resolution (≤1 bleeding sites, probing depth [PD] ≤5 mm, no bone loss >0.5 mm). Multilevel regression analyses were used to identify predictors influencing the probability of attaining disease resolution.ResultsOne hundred and seventeen patients with 338 implants were included. Disease resolution was attained in 54.4% of the 338 implants receiving flapless surgical access. At the end of the follow‐up period, 111 patients (94.9%) with 295 implants (87.3%) did not require any further treatment, with 81.4% of these implants presenting PD ≤ 5 mm. History of periodontitis and PD at baseline were identified as negative predictors, while compliance with supportive peri‐implant care, a machined surface and the adjunctive use of systemic azithromycin or metronidazole were identified as positive predictive factors for disease resolution.ConclusionsA flapless surgical approach led to disease resolution in 54.4% of the implants with peri‐implantitis. Several risk/protective predictors for disease resolution were identified.