A prospective case series on surgical treatment of circumferential and semi-circumferential defects due to peri-implantitis.

Luigi Canullo,Roberto Pistilli,Luca Signorini,Romeo Patini,Valeria Pistilli,Paolo Pesce

doi:10.1590/1807-3107bor-2019.vol33.0072

Abstract

Different surgical treatment strategies for peri-implantitis with the use of graft material and membranes have been suggested without any longitudinal remarkable success rate. The present preliminary study was aimed to analyze a new clinical approach based on the disinfection of the implant connection, the disinfection of the implant surface and GBR approach in the treatment of circumferential and semi-circumferential bony defect resulting from peri-implantitis. Six consecutive patients were selected for the present study. After removal of factors that could potentially influence peri-implant pathology, the prosthetic rehabilitation was always removed and a full thickness flap was elevated to allow access to the peri-implant defect and the exposed implant surface. Once the defect was degranulated and the implant surface cleaned, a mixture (50:50) of autogenous bone and allograft was used. Guided bone regeneration technique using membranes was adopted and the flaps were closed for a submerged healing. Six months thereafter, a new re-opening procedure was performed and cleaned superstructures and crowns were repositioned. Patients were followed for one year thereafter and recalled for a customized oral hygiene every three months. Radiological and periodontal analysis was performed before surgery and every six months. The studied procedure was associated with a pronounced increase in REC and CAL with stable peri-implant conditions at 6 and 12 months. PI, BOP and PD values were significantly reduced both at 6 and 12 months. At 12 months, a mean PD gain of 4.5 mm and a bone loss reduction of 5.1 mm was obtained. Within the limitation of the present preliminary study, the proposed technique might represent a promising result for treatment of circumferential and semi-circumferential bone defects around implants affected by peri-implantitis.

Highlights

Nowadays the pathological conditions termed “mucositis” and “peri-implantitis” are considered the major complication in dental implantology.[1]Braz
The present preliminary study was aimed to analyze a new clinical approach based on the disinfection of the implant connection, disinfection of the implant surface and Guided Bone Regeneration (GBR) approach in the treatment of circumferential and semi-circumferential bony defect resulting from peri-implantitis
In January 2016, in three different clinical centers in Rome, a preliminary prospective clinical trial was designed to test the efficacy of a GBR protocol in the treatment of bony defect resulting from peri-implantitis

Summary

Introduction

Nowadays the pathological conditions termed “mucositis” and “peri-implantitis” are considered the major complication in dental implantology.[1]Braz. Nowadays the pathological conditions termed “mucositis” and “peri-implantitis” are considered the major complication in dental implantology.[1]. A recent review reported that the prevalence of peri-implant mucositis and peri-implantitis ranged from 19 to 65% and from 1 to 47%, respectively. The meta-analyses revealed a weighted mean prevalence of peri-implant mucositis and peri-implantitis of 43% and 22%, respectively.[2]. Case definitions varied among the scientific literature.[2] As a consequence, implant defined as affected by some authors might not be considered affected by other authors if another definition is used. The prevalence could broadly vary between studies.[3]

Methods

Results

Conclusion