Volumetric assessment of tissue changes following combined surgical therapy of peri-implantitis: A pilot study.

Abstract

To assess volumetric tissue changes at peri-implantitis sites following combined surgical therapy of peri-implantitis over a 6-month follow-up period. Twenty patients (n=28 implants) diagnosed with peri-implantitis underwent access flap surgery, implantoplasty at supracrestally or bucally exposed implant surfaces and augmentation at intra-bony components using a natural bone mineral and application of a native collagen membrane during clinical routine treatments. The peri-implant region of interest (ROI) was intra-orally scanned pre-operatively (S0), and after 1 (S1) and 6 (S2) months following surgical therapy. Digital files were converted to standard tessellation language (STL) format for superimposition and assessment of peri-implant volumetric variations between time points. The change in thickness was assessed at a standardized ROI, subdivided into three equidistant sections (i.e. marginal, medial and apical). Peri-implant soft tissue contour area (STCA) (mm2 ) and its corresponding contraction rates (%) were also assessed. Peri-implant tissues revealed a mean thickness change (loss) of -0.11 and -0.28mm at 1 and 6months. S0 to S1 volumetric variations pointed to a thickness change of -0.46, 0.08 and 0.4mm at marginal, medial and apical regions, respectively. S0 to S2 analysis exhibited corresponding thickness changes of -0.61, -0.25 and -0.09mm, respectively. The thickness differences between the areas were statistically significant at both time periods. The mean peri-implant STCA totalled to 189.2, 175 and 158.9mm2 at S0, S1 and S2, showing a significant STCA contraction rate of 7.9% from S0 to S1 and of 18.5% from S0 to S2. Linear regression analysis revealed a significant association between the pre-operative width of keratinized mucosa (KM) and STCA contraction rate. The peri-implant mucosa undergoes considerable volumetric changes after combined surgical therapy. However, tissue contraction appears to be influenced by the width of KM.