Successful Management of Peri-Implantitis around Short and Ultrashort Single-Crown Implants: A Case Series with a 3-Year Follow-Up.

Giorgio Lombardo,Miguel Angel Simancas-Pallares,Luisa Arevalo-Tovar,Giovanni Corrocher,Luis Armando Vila Sierra,Annarita Signoriello,Pier Francesco Nocini,Jacopo Pighi,Xiomara Serpa-Romero,Mauro Marincola,Andrea Cicconetti,Jeffrey Lehrberg

doi:10.1155/2019/5302752

Abstract

Introduction and Aim In case of peri-implantitis, resective surgery is contraindicated for short and ultrashort implants, limiting the treatment options to regenerative surgery or to implant removal. This retrospective case series presents the clinical and radiographic outcomes of a surgical regenerative procedure to treat peri-implantitis around short and ultrashort implants. Materials and Methods The study is a retrospective evaluation of patients suffering from peri-implantitis and those who underwent access flap surgery, concomitant chemical and mechanical decontamination of implant surface, and bone grafting using a self-hardening mixture of bone substitutes and biphasic calcium sulfate. No membranes were applied to cover the grafting material, and primary tension-free closure was achieved. The retrospective protocol was reviewed and approved by the Ethics Committee for Clinical Sperimentation (CESC) of Verona and Rovigo, Italy (based in the University of Verona) (Prog. 1863CESC. Date of approval: 2018-07-04). Results 15 patients (17 implants) have been diagnosed with peri-implantitis after a mean follow-up of 24 months after loading. Implant length was between 5 and 8 mm. 8 patients (10 implants) had a history of periodontitis. At baseline, the mean PD (probing pocket dept) at the deepest site was 8.12 mm, with an average mBI (modified bleeding index) of 2.35 and a mean BD (bone defect depth) of 3.04 mm. At the 3-year follow-up, the CSR was 100%, the mean mBI was 0.88 (average reduction: −1.47), the mean PD was 3.35 mm (mean PD reduction: 4.77 mm), and the mean bone defect was reduced by 1.74 mm, with a mean bone fill of 55%. Conclusions The results of the present case series suggest that if accurate surface decontamination is achieved, high survival rate and good clinical and radiographic results can be obtained after 3 years. However, only the histological examination could confirm the growth of new bone in direct contact with the implant surface or if the grafted material only fills the space left by the peri-implant defect.

Highlights

Introduction and AimIn case of peri-implantitis, resective surgery is contraindicated for short and ultrashort implants, limiting the treatment options to regenerative surgery or to implant removal. is retrospective case series presents the clinical and radiographic outcomes of a surgical regenerative procedure to treat peri-implantitis around short and ultrashort implants
Regenerative surgery is conditioned by two critical phases, the implant surface decontamination and the defect grafting and/or membrane coverage [7]. e quality and quantity of biofilm attached to the implant surface are significantly influenced by the implant’s surface roughness and by implant macrogeometry since rough surfaces tend to accumulate more plaque, and bacterial adhesion starts inside the pits and grooves of the roughened surfaces, wherefrom mechanical removal techniques alone are ineffective [8]
We report the three-year results of a regenerative treatment protocol for peri-implantitis that combines the concomitant use of a desiccant agent and an abrasive air powder treatment to decontaminate the implant’s surface with the use of a composite graft without the use of membrane

Summary

Introduction

Introduction and AimIn case of peri-implantitis, resective surgery is contraindicated for short and ultrashort implants, limiting the treatment options to regenerative surgery or to implant removal. is retrospective case series presents the clinical and radiographic outcomes of a surgical regenerative procedure to treat peri-implantitis around short and ultrashort implants. In case of peri-implantitis, resective surgery is contraindicated for short and ultrashort implants, limiting the treatment options to regenerative surgery or to implant removal. E quality and quantity of biofilm attached to the implant surface are significantly influenced by the implant’s surface roughness and by implant macrogeometry since rough surfaces tend to accumulate more plaque, and bacterial adhesion starts inside the pits and grooves of the roughened surfaces, wherefrom mechanical removal techniques alone are ineffective [8] For this reason, in the literature, several chemical topical agents have been proposed in addition to open flap mechanical debridement, but it is hardly possible to compare their adjunctive effect since the grafting protocol differs between one research and another, and there are only few RCTs [9] Regenerative surgery is conditioned by two critical phases, the implant surface decontamination and the defect grafting and/or membrane coverage [7]. e quality and quantity of biofilm attached to the implant surface are significantly influenced by the implant’s surface roughness and by implant macrogeometry since rough surfaces tend to accumulate more plaque, and bacterial adhesion starts inside the pits and grooves of the roughened surfaces, wherefrom mechanical removal techniques alone are ineffective [8].

Methods

Results

Conclusion