Anti‐infective surgical therapy of peri‐implantitis. A 12‐month prospective clinical study

Abstract

The aim of this prospective cohort study was to evaluate an anti-infective surgical protocol for the treatment of peri-implantitis. Thirty-six implants in 24 partially dentate patients with moderate to advanced peri-implantitis were treated using an anti-infective surgical protocol incorporating open flap debridement and implant surface decontamination, with adjunctive systemic amoxicillin and metronidazole. Treatment outcomes were assessed at 3, 6 and 12months. Patient-based statistical analyses using multiple regression analyses were performed. There was 100% survival of treated implants at 12months. At 3months, there were statistically significant (P<0.01) reductions in mean probing depths (PD), Bleeding on Probing (BoP) and suppuration. The greater the mean PD at baseline, the greater the PD reduction at 3months. At 3months, there was also a significant mean facial mucosal recession of 1mm (P<0.001). All these changes were maintained at 6 and 12months. At 12months, all treated implants had a mean PD<5mm, while 47% of the implants had complete resolution of inflammation (BoP negative). At 12months, 92% of implants had stable crestal bone levels or bone gain. There were no significant effects of smoking on any of the treatment outcomes. For the treatment of peri-implantitis, an anti-infective protocol incorporating surgical access, implant surface decontamination and systemic antimicrobials followed by a strict postoperative protocol was effective at 3months with the results maintained for up to 12months after treatment.