Abstract

To assess the clinical and radiographic outcomes applying a combined resective and regenerative approach in the treatment of peri-implantitis. Subjects with implants diagnosed with peri-implantitis (i.e., pocket probing depth (PPD) ≥5mm with concomitant bleeding on probing (BoP) and ≥2mm of marginal bone loss or exposure of ≥1 implant thread) were treated by means of a combined approach including the application of a deproteinized bovine bone mineral and a collagen membrane in the intrabony and implantoplasty in the suprabony component of the peri-implant lesion, respectively. The soft tissues were apically repositioned allowing for a non-submerged healing. Clinical and radiographic parameters were evaluated at baseline and 12months after treatment. Eleven subjects with 11 implants were treated and completed the 12-month follow-up. No implant was lost yielding a 100% survival rate. At baseline, the mean PPD and mean clinical attachment level (CAL) were 8.1±1.8mm and 9.7±2.5mm, respectively. After 1year, a mean PPD of 4.0±1.3mm and a mean CAL of 6.7±2.5mm were assessed. The differences between the baseline and the follow-up examinations were statistically significant (P=0.001). The mucosal recession increased from 1.7±1.5 at baseline to 3.0±1.8mm at the 12-month follow-up (P=0.003). The mean% of sites with BoP+ around the selected implants decreased from 19.7±40.1 at baseline to 6.1±24.0 after 12months (P=0.032). The radiographic marginal bone level decreased from 8.0±3.7mm at baseline to 5.2±2.2mm at the 12-month follow-up (P=0.000001). The radiographic fill of the intrabony component of the defect amounted to 93.3±13.0%. Within the limits of this study, a combined regenerative and resective approach for the treatment of peri-implant defects yielded positive outcomes in terms of PPD reduction and radiographic defect fill after 12months.

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