Peri‐implant tissue conditions at implants treated with Sub‐periosteal Peri‐implant Augmented Layer technique: A retrospective case series

Abstract

Objectives: To assess peri-implant tissue conditions on the short term in patients receiving the Sub-periosteal Peri-implant Augmented Layer (SPAL) technique and in patients with adequate thickness (≥2 mm) of the peri-implant buccal bone plate (PBBP) at placement. Methods: Patients where either a dehiscence defect or thin PBBP at implant placement was corrected by SPAL technique (SPAL dehiscence and SPAL thin groups, respectively) and patients presenting a residual PBBP thickness ≥2 mm at implant placement (control group) were retrospectively selected. The number of peri-implant sites positive to bleeding on probing (BoP) at 6 months following prosthetic loading was the primary outcome. Also, height of keratinized mucosa, marginal soft tissue level, Plaque Index, peri-implant probing depth, suppuration on probing, and interproximal radiographic bone level (RBL) were evaluated. Results: Thirty-four patients (11 in the SPAL dehiscence group, 11 in the SPAL thin group, and 12 in the control group) were included. In each SPAL group, 10 patients (90.9%) showed peri-implant tissue thickness ≥2 mm at the most coronal portion of the implant at uncovering. The prevalence (number) of BoP-positive sites was 2, 1, and 0 in the SPAL dehiscence , SPAL thin , and control groups, respectively. RBL amounted to 0.3 mm in the SPAL dehiscence group, 0.2 mm in the SPAL thin group, and 0 mm in the control group. Conclusion: After 6 months of prosthetic loading, patients treated with SPAL technique show limited peri-implant mucosal inflammation in association with shallow PD and adequate KM. At implants receiving SPAL technique, however, interproximal RBL was found apical to its ideal position. K E Y W O R D S bone regeneration, dental implants, oral surgical procedures | 993 TROMBELLI ET aL.

Peri‐Implant Bone Augmentation by the Sub‐Periosteal Peri‐Implant Augmented Layer Technique and a Bovine‐Derived Bone Block: A Case Report

“…Clinical observations stemming from the present case report cumulate with previous evidence from case reports 2,5 and retrospective case series 3,4 on the SPAL technique. Overall, data demonstrate that SPAL can be successfully used for peri-implant bone augmentation with a bovine-derived xenograft in a variety of clinical scenarios in terms of implant topography (i.e., anterior/posterior sextant 3 and maxillary/mandibular arch 3,4 ) as well as conditions of the buccal bone plate at the time of implant placement. In particular, clinically relevant augmentation was reported for implants with either a buccal bone dehiscence or an intact but thin buccal bone plate at placement, 4 Within implants with bone dehiscence, defect depths up to 6 mm were successfully corrected with SPAL.…”

“…Overall, data demonstrate that SPAL can be successfully used for peri-implant bone augmentation with a bovine-derived xenograft in a variety of clinical scenarios in terms of implant topography (i.e., anterior/posterior sextant 3 and maxillary/mandibular arch 3,4 ) as well as conditions of the buccal bone plate at the time of implant placement. In particular, clinically relevant augmentation was reported for implants with either a buccal bone dehiscence or an intact but thin buccal bone plate at placement, 4 Within implants with bone dehiscence, defect depths up to 6 mm were successfully corrected with SPAL. Unfortunately, although encouraging, the available data is not sufficient to either clearly delineate the local indications/contraindications of the SPAL technique or clarify which factors may influence the clinical outcomes of the procedure.…”

“…2 Previous studies have shown that SPAL may result in a substantial dehiscence correction, 3,4 thus providing conditions for periimplant health at the treated implants. 4 Also, SPAL has been shown effective in treating dehiscence-type periimplantitis defects associated with either an interproximal or a circumferential component. 5 In all cases treated with SPAL, a deproteinized bovine bone mineral (DBBM)-delivered as a particulate-has been accommodated between the periosteal layer and the exposed implant surface.…”

Effect of lateral bone augmentation procedures in correcting peri‐implant bone dehiscence and fenestration defects: A systematic review and network meta‐analysis

“…Eighteen studies were included for the analysis. NHBS and HBS were employed in 13 6,25,30,33–42 and 5 23,26,28,29,31 studies, respectively. Deproteinized bovine bone mineral and autologous bone were the most used NHBS and HBs, respectively.…”

“…Details of the included studies are reported in Table 1. Twenty‐three studies reported data on BD 6,21–42 whereas one study reported data on BF 20 . Quality assessment of the included studies is reported in Appendices 3 and 4.…”