Abstract
Objectives: The present randomized clinical trial assesses the six-month outcomes following surgical regenerative therapy of periimplantitis lesions using either an electrolytic method (EC) to remove biofilms or a combination of powder spray and electrolytic method (PEC). Materials and Methods: 24 patients with 24 implants suffering from peri-implantitis with any type of bone defect were randomly treated by EC or PEC. Bone defects were augmented with a mixture of natural bone mineral and autogenous bone and left for submerged healing. The distance from implant shoulder to bone was assessed at six defined points at baseline (T0) and after six months at uncovering surgery (T1) by periodontal probe and standardized x-rays. Results: One implant had to be removed at T1 because of reinfection and other obstacles. None of the other implants showed signs of inflammation. Bone gain was 2.71 ± 1.70 mm for EC and 2.81 ± 2.15 mm for PEC. No statistically significant difference between EC and PEC was detected. Significant clinical bone fill was observed for all 24 implants. Complete regeneration of bone was achieved in 12 implants. Defect morphology impacted the amount of regeneration. Conclusion: EC needs no further mechanical cleaning by powder spray. Complete re-osseointegration in peri-implantitis cases is possible.
Highlights
Increasing numbers of inserted dental implants cause an increasing number of infected implants [1]
All the sites were infected, bleeding on probing (BoP) was positive, pus drained from pockets, and all sites probed deeper than 5 mm at baseline (Table 1)
In an animal study [27], we proved that complete re-osseointegration could be achieved after the use of electrolytic method (EC), whereas with conventional cleaning, the bone filled the defect partially, but was never in direct contact with the implant
Summary
Increasing numbers of inserted dental implants cause an increasing number of infected implants [1]. Mucositis is a reversible inflammatory process limited to peri-implant soft tissue. Peri-implantitis (PI) is defined as an inflammatory process affecting peri-implant hard as well as soft tissue. Mucositis and PI are correlated with bacterial biofilms colonizing the surfaces of implants or abutments [4]. In view of the difficulty in differentiating pathologic bleeding from bleeding caused by improper probing, as well as the discordance in the dental community about the acceptable threshold of bone loss, there is no consensus about when pathology starts and how PI can be diagnosed precisely. Prevalence data vary from author to author [5,6] Based on these data, up to 100 million dental implants may be infected worldwide. It is necessary to find more effective approaches to decontaminating infected implants
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