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Clinical and Radiographic Outcomes of a Surgical Reconstructive Approach in the Treatment of Peri-Implantitis Lesions: A 5-year Prospective Case Series

Clinical and Radiographic Outcomes of a Surgical Reconstructive Approach in the Treatment of Peri-Implantitis Lesions: A 5-year Prospective Case Series

Gerardo La Monaca, Nicola Pranno, Susanna Annibali, Maria Paola Cristalli, Antonella Polimeni

Clin Oral Implants Res. 2018 Oct;29(10):1025-1037.

PMID: 30267445

Abstract:

Objectives:
The aim of this study was to evaluate the 5-year clinical and radiographic outcomes following reconstructive therapy of peri-implantitis lesions using mineralized dehydrated bone allograft and resorbable membrane in the nonsubmerged mode of wound healing.
Materials and methods:
Thirty-four patients with at least one implant diagnosed with peri-implantitis were treated by mechanical debridement; chemical decontamination using hydrogen peroxide (3%), chlorhexidine (0.2%), and a tetracycline hydrochloride solution; and bone defect filling with mineralized dehydrated bone allograft and resorbable membrane. Clinical and radiographic assessments were obtained during 5-year follow-up. The primary outcome was the absence of additional marginal peri-implant bone loss ≥1.0 mm after surgery, and the composite outcome included the additional marginal peri-implant bone loss, absence of probing depth (PD) ≥5 mm, and absence of bleeding on probing (BoP)/suppuration.
Results:
According to the primary and composite outcomes, the success rate of 34 implants included in the study was 100% and 91% (N = 31), at 1 year after surgery, and decreased progressively to 77% (N = 26) and to 59% (N = 20) at 5-year follow-up, respectively. Five years following treatment, only the BoP reduction was statistically significant compared to baseline (p < 0.001), and no difference was found in PD (p = 0.318) and in marginal peri-implant bone level (p = 0.064).
Conclusions:
At 1-year follow-up, the surgical reconstructive therapy showed clinical improvement and radiographic defect filling. However, the results appeared to be unpredictable over time, due to a progressive decrease in the bone filling of the peri-implant defects and an increase in the mean PD.

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