Outcome indicators of non-surgical therapy of peri-implantitis: a prospective case series analysis.

Vilarrasa, Javi; Soldini, Maria Costanza; Pons, Ramón; Valles, Cristina; Blasi, Gonzalo; Monje, Alberto; Nart, José (2023). Outcome indicators of non-surgical therapy of peri-implantitis: a prospective case series analysis. Clinical oral investigations, 27(6), pp. 3125-3138. Springer-Verlag 10.1007/s00784-023-04918-2

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OBJECTIVES

This study aims to identify patient and implant indicators influencing the non-surgical therapeutic outcomes of peri-implantitis at 6 months of follow-up.

METHODS

This case series involved patients with at least one implant diagnosed with peri-implantitis according to the 2017 World Workshop criteria. Non-surgical therapy consisted of mechanical debridement of the peri-implant pockets combined with metronidazole 500 mg 3 times a day for 7 days. At baseline and at 6 months, clinical and radiographic variables were collected to calculate treatment success (probing pocket depth reduction to 5 mm without bleeding on probing or < 5 mm irrespective of bleeding on probing at all implant sites, and lack of bone loss progression). The primary outcome was treatment success (%) at 6 months. The influence of the patient and implant/prosthetic variables upon disease resolution was assessed through simple and multiple logistic regression analyses at patient and implant level, using generalized estimation equations models.

RESULTS

A total of 74 patients and 107 implants were analyzed at 6 months. Disease resolution was established in 25.7% of the patients and 24.1% of the implants. Patients with stage IV and grade C periodontitis, inadequate oral hygiene at baseline, and wide diameter (≥ 4.5 mm) presented significantly greater treatment failure, whereas smokers and former smokers demonstrated a tendency toward failure. At 6 months, there was a significant decrease in probing pocket depth and bleeding on probing of 1.08 ± 1.06 mm and 14%, respectively. Radiographically, a significant gain in marginal bone level of 0.43 ± 0.56 mm was observed.

CONCLUSION

Disease resolution after non-surgical treatment of peri-implantitis is negatively influenced by the loss of support of the adjacent periodontium, poor baseline oral hygiene, and wide diameter implants (≥ 4.5 mm).

CLINICAL RELEVANCE

This study helps to discriminate the clinical situations in which non-surgical treatment is less likely to achieve treatment success at short term.

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5 Citations in Web of Science ®
6 Citations in Scopus

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