Reconstructive therapy for the management of peri-implantitis via submerged guided bone regeneration: A prospective case series.

Monje, Alberto; Pons, Ramón; Roccuzzo, Andrea; Salvi, Giovanni E.; Nart, José (2020). Reconstructive therapy for the management of peri-implantitis via submerged guided bone regeneration: A prospective case series. Clinical implant dentistry and related research, 22(3), pp. 342-350. Blackwell 10.1111/cid.12913

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BACKGROUND

The present case series assesses the response to reconstructive therapy for the management of 2/3-wall peri-implantitis bone defects following submerged-healing guided bone regeneration.

MATERIAL AND METHODS

Fifteen consecutive patients with 27 implants presenting peri-implantitis were included. Guided bone regeneration was applied by means of autogenous bone/deproteinized bovine bone mineral grafting mixture and collagen membrane. Patients were assessed at baseline (T0) and at 6 (T1) and 12 months (T2). Clinical and radiographic variables defined the composite success criteria (probing pocket depth [PPD] ≤ 5 mm, no bleeding on probing/suppuration (SUP), no further radiographic bone loss). Patient site-specific comfort was scored using a visual analog scale (VAS). Descriptive statistics was carried out to assess the changes along the study period. Outcomes are reported in terms of mean values (5%-95% percentile values).

RESULTS

All the clinical variables substantially changed from T0 through T2. In particular, PPD decreased 3.7 mm (0.7-5.9) from T0 to T2. Likewise, the scores for the modified plaque index (mPI) and modified sulcular bleeding index (mBI) were reduced by 0.5 (-0.5-1.1) and 1.6 (0.4-2.4), respectively. SUP did not display at any implant site at T2 (59.2% implants in 29.2% patients suppurated at T0). Keratinized mucosa decreased 0.6 mm (-0.2-4.4) and while mucosal recession increased 2.5 mm (1.0-4.3). Alike, the radiographic parameters varied significantly from T0 through T2. Infrabony defects were filled by 2.2 mm (0.0-8.6) at T2 and marginal bone loss was reduced by 2.3 mm (-1.1-8.1). The mean VAS score significantly increased from T0 (56.7) through T1 to T2, reaching a score of 96 at T2. At this timepoint, 85.2% of the peri-implantitis lesions were resolved.

CONCLUSIONS

The proposed surgical approach followed by submerged healing to reconstruct peri-implant bone defects may offer one therapeutic option for failing dental implants. Given the nature of the present study, its effectiveness in comparison to less invasive treatments needs investigation in randomized controlled trials.

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