Peri-implantitis: explantation versus peri-implant regeneration

Abstract

Peri-implantitis is a complication in implantprosthetic rehabilitation that causes morpho-functional, masticatory and aesthetic disorders. Depending on the severity it can be approached by conservative surgical or radical treatment. The aim of the paper is the comparative analysis of conservative surgical methods (implant preservation) versus radical (explantation). We studied 2 patients who came to the SRL “Omni Dent” clinic with peri-implantitis. Manifestation, treatment and evolution in both patients were compared. Analysis criteria: bone defect extension, soft tissue appearance, tissue regeneration, implant-prosthetic rehabilitation time. In RI patient there were changes in color and appearance of the peri-implant soft tissues (hyperemia, edema, purulent discharge), peri-implant radiolucency on the entire implant surface; in the TM patient there were the same clinical signs but limited to ½ implant length. RI patient underwent explantation with re-implantation in the neighboring region 2.4 after 4 months with prosthesis fixing after another 4 months. Tissue regeneration evolved without complications. In TM patient was decided to keep the implant through curettage, implantoplasty and bone addition. Prosthetic rehabilitation followed later without complications. Timely addressing would prevent the development of complications with implant loss. The insignificant loss of peri-implant tissues can be recovered with the preservation of the implant, in the extended defects the optimal solution is the explantation with the subsequent implantprosthetic rehabilitation.