Influence of Removing or Leaving the Prosthesis after Regenerative Surgery in Peri-Implant Defects: Retrospective Study: 32 Clinical Cases with 2 to 8 Years of Follow-Up

Abstract

Purpose: The aim of this retrospective study was to compare the influence of removing or not removing a prosthesis after regenerative surgery on peri-implant defects. Methods: Two different groups were compared (Group 1: removing the prosthesis; Group 2: maintaining the prosthesis), analyzing radiographic bone filling (n = 32 implants) after regenerative treatment in periapical radiographs. The peri-implant defects were measured before and after regenerative treatment using Bio-Oss® (Geistlich Pharma, Wohhusen, Switzerland) and a reabsorbable collagen membrane (Jason®, Botis, Berlin, Germany), the healing period was two years after peri-implant regenerative surgery. Statistical analysis was performed, and a Chi square test was carried out. To determine the groups that made the difference, corrected standardized Haberman residuals were used, and previously a normality test had been applied; therefore, an ANOVA or Mann–Whitney U test was used for the crossover with the non-normal variables in Group 1 and Group 2. Results: The results obtained suggest that a regenerative procedure with xenograft, resorbable membrane, and detoxifying the implant surface with hydrogen peroxide form a reliable technique to achieve medium-term results, obtaining an average bone gain at a radiographic level of 2.84 mm (±1.78 mm) in patients whose prosthesis was not removed after peri-implant bone regenerative therapy and 2.18 mm (±1.41 mm) in patients whose prosthesis was removed during the healing period. Conclusions: There are no statistically significant differences in the response to treatment when removing or keeping the prosthesis after regenerative surgery in peri-implant defects.

Minimal invasiveness in the reconstructive treatment of peri‐implantitis defects

“…However, after screening for titles and abstracts, only two recently published manuscripts focusing on reconstructive therapy of periimplantitis were identified. 15,16 Therefore, it was decided to remove the term "minimal invasiveness" from the search strategy and update the search from February 2018 to July 2021. This search yielded 305 articles published since February 2018.…”

“…Nevertheless, and independently of the surgical approach chosen for the treatment of peri-implantitis, the occurrence of mucosal recession after surgery should be avoided to the best of our capabilities, because the unveiling of the grayish metallic cervical portion of the implant to the oral cavity, independently of its size, may compromise patients' esthetics and satisfaction, especially when it occurs on implants located in the anterior region. 16 The use of minimally invasive flaps could minimize the apical migration of the peri-implant mucosal margin after surgery. In 2018,…”

“…A recent systematic review with meta‐analysis on the efficacy of the reconstructive treatment of peri‐implantitis estimated a statistically significant weighted mean recession of −0.65 mm (95% confidence interval: [−0.97; −0.33]), 12 months after treatment, 9 while a previous systematic review reported a nonstatistically significant weighted mean mucosal gain of 0.22 mm (95% confidence interval: [−0.07; 0.51]) after 36 months of follow‐up. Nevertheless, and independently of the surgical approach chosen for the treatment of peri‐implantitis, the occurrence of mucosal recession after surgery should be avoided to the best of our capabilities, because the unveiling of the grayish metallic cervical portion of the implant to the oral cavity, independently of its size, may compromise patients' esthetics and satisfaction, especially when it occurs on implants located in the anterior region 16 …”

Incidence of Peri-Implantitis and Relationship with Different Conditions: A Retrospective Study

“…However, there are other factors with less evidence in the literature, such as medical history (diabetes, arterial hypertension, alcohol habits), the presence of at least 2 mm of keratinized mucosa, excess cement in rehabilitation, and prosthetic characteristics [ 8 ]. Therefore, peri-implant risk factors must be determined because they can influence the evolution and results of treatment [ 9 ].…”