Surgical treatment of peri-implantitis.

Surgical treatment of peri-implantitis lesions can be performed in cases with considerable pocket formation (larger than 5 mm) and bone loss after the acute infection has been resolved and proper oral hygiene has been instituted. A literature review was conducted to ascertain current knowledge about surgical treatment options for peri-implantitis around commercially pure titanium implants. Recently reported animal studies involving implants with a rough surface indicate that considerable bone regeneration and re-osseointegration can be obtained by using membrane-covered autogenous bone graft particles. However, comparisons of the treatment outcomes in studies involving humans and animals are difficult because of differences in implant type, graft type, and evaluation protocols. In addition, different treatment procedures, including implant surface decontamination methods, have been used. Therefore, further long-term studies in humans involving sufficient numbers of subjects are needed to provide a solid basis for recommendations regarding the surgical treatment of peri-implantitis. Moreover, the encouraging treatment outcomes of regenerative procedures recently revealed in animal experiments and applied in the treatment of peri-implantitis around implants with sandblasted/acid-etched surfaces have not yet been documented for implants with other surfaces, especially turned surfaces. Numerous implant surface decontamination methods have been suggested as part of the surgical treatment of peri-implantitis. Decontamination of affected implants with titanium plasma-sprayed or sandblasted/acid-etched surfaces may most easily and effectively be achieved by applying gauze soaked alternately in chlorhexidine and saline.