Prospective longitudinal comparison study of surgical therapies for peri‐implantitis: 3‐year follow‐up

Abstract

Background: The aim of this study was to compare different surgical therapies to treat peri-implantitis. Methods: Twenty-three patients presenting one implant affected by peri-implantitis were divided into three groups: (i) open flap debridement (OFD) and citric acid decontamination (CAD); (ii) OFD, CAD and subepithelial connective tissue graft (SCTG); (iii) OFD, CAD and implantoplasty. Modified plaque index (MPI), gingival bleeding index (GBI), keratinized mucosa (KM) width, probing depth (PD), bleeding or suppuration on probing (B/SOP), and radiographic crestal bone level were registered 1(T1), 2(T2) and 3(T3) years after treatment. Results: In Group 1 there was a significant improvement in MPI from baseline to T1, and a significant reduction in PD over time. In Group 2, none of the assessed clinical parameters showed any statistically significant variation over time. In Group 3, there was a significant decrease in PD and B/SOP over time. When comparing the 3 Groups, KM was significanlty greater in Group 2 vs. Group 1 and Group 3 at T1 and T2, and in Group 2 vs. Group 3 at T3. Conclusion: All therapies were successful in the management of peri-implantitis; however, SCTG maintained the greatest KM width. Surgical therapies combined with mechanical and chemical decontamination contributed to peri-implant tissue health.Abbreviations and acronyms: B/SOP = bleeding or suppuration on probing; CBL = crestal bone level; PD = probing depth; SCTG = subepithelial connective tissue graft.

Volumetric assessment of tissue changes following combined surgical therapy of peri‐implantitis: a pilot study

“…A slight increase in mean MR was merely noted at two out of 13 implant sites, amounting to 0.3 and 1.0 mm, respectively (Schwarz et al, 2014). The beneficial effect of a volume grafting procedure using connective tissue on peri-implant soft tissue stability was also demonstrated when used along with open flap debridement alone (Dalago et al, 2019).…”

Efficacy of Titanium Brush, 915 nm Diode Laser, Citric Acid for Eradication of Staphylococcus Aureus from Implant Surfaces

“…Dalago et al in their clinical trial in 2019, highlighted the signi cance of using citric acid as the most e cient chemical agent following mechanical debridement on 27 patients. They used 50% citric acid gel (pH of 1) for 3 minutes [30]. Concentration, form and duration of citric acid application in their study were different from ours; however, the results showed that citric acid, either alone or in combination with other modalities such as subepithelial connective tissue grafts or implantoplasty, could be effective in the treatment of peri-implantitis and increase the survival rate of implants.…”

Implantoplasty- provoking or reducing inflammation? – a systematic scoping review

“…In Lasserre et al [45], implantoplasty was performed without bone recontouring and compared to treatment with glycine air-polishing. In Dalago et al [46], open flap debridement with adjunctive implantoplasty was compared to open flap debridement with and without subepithelial connective tissue graft.…”

“…Of the 14 studies with uniqe study populations included in this scoping review, 3 were controlled studies randomised with respect to adjunctive implantoplasty; Romeo et al [16,17]; Lasserre et al [45]; Dalago et al [46], 8 prospective studies [18,[32][33][34][36][37][38][39][40]42,43], 2 retrospective studies [35,44], and 1 retrospective case-control study [41] (Figure 1) (Table 2).…”

“…All but one study presented a reduction of BoP in the follow-up visit compared to the baseline (Table 3). Five studies included more than one follow-up time [16][17][18][32][33][34]36,45,46], and these demonstrated either sustained low values or further reduction of BoP over time.…”