Abstract
ObjectiveTo evaluate re-osseointegration after electrolytic cleaning and regenerative therapy of dental implants with peri-implantitis in humans.Material and methodsFour dental implants that developed peri-implantitis underwent electrolytic cleaning followed by regenerative therapy with guided bone regeneration. All four implants developed recurrent peri-implantitis and were therefore explanted 6 to 13 months later. Radiographic bone level, probing depth, and bleeding on probing were determined at the time of surgery, 6 months later, and before implant retrieval. The peri-implant tissues were histologically and histomorphometrically analyzed.ResultsAll four implants demonstrated radiographic and histological bone gain, reduced probing depth, and bleeding on probing. Radiographic bone gain was 5.8 mm mesially and 4.8 mm distally for implant #1, 3.3 mm and 2.3 mm for implant #2, 3.1 mm and 0.5 mm for implant #3, and 3.5 mm and 2.8 mm for implant #4. The histometric mean and maximum vertical bone gain for implant #1 to #4 was 1.65 mm and 2.54 mm, 3.04 mm and 3.47 mm, 0.43 mm and 1.27 mm, and 4.16 mm and 5.22 mm, respectively. The percentage of re-osseointegration for implant #1 to #4 was 21.0%, 36.9%, 5.7%, and 39.0%, respectively. In one implant, the newly formed bone was deposited directly onto calculus on the implant surface.ConclusionsWe found that (1) re-osseointegration is possible on a formerly contaminated implant surface and (2) the electrolytic cleaning process seems to be effective enough at sites with calculus residues.Clinical relevanceSince re-osseointegration can be achieved by electrolytic cleaning, this decontamination technique may be considered as a future treatment concept.
Highlights
Dental implants have become a predictable and effective treatment option for the replacement of missing teeth in completely and partially edentulous patients
A frequent biological complication is the development of peri-implantitis, a pathological condition occurring in tissues around dental implants
The prevalence rates of peri-implantitis reported in studies vary greatly due to heterogeneous disease definitions and differences applied for case definitions [2]
Summary
Dental implants have become a predictable and effective treatment option for the replacement of missing teeth in completely and partially edentulous patients. Complications do occur and can compromise implant longevity [2]. Clinical Oral Investigations (2022) 26:3735–3746 can be anticipated that the number of complications will increase over time as well. A frequent biological complication is the development of peri-implantitis, a pathological condition occurring in tissues around dental implants. Peri-implantitis is a biofilm-associated pathological condition, characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone [3]. The inflammatory process is caused by bacteria that form a biofilm on the implant surface, resulting in soft tissue degradation, peri-implant pocket formation, and bone resorption. The loss of bone exposes the implant surface and leads to esthetic problems and compromises osseointegration. The prevalence rates of peri-implantitis reported in studies vary greatly due to heterogeneous disease definitions and differences applied for case definitions [2]. A systematic review with meta-analysis reported a weighted mean prevalence of 22% for peri-implantitis, with a range of 1 to 45% [4]
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