Tord Berglundh1, Jan L Wennström1, Jan Lindhe1. 1. Department of Periodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden.
Abstract
OBJECTIVE: To assess long-term clinical and radiological outcomes of surgical treatment of peri-implantitis. MATERIAL AND METHODS: Files and radiographs from 50 patients who had received surgical treatment for peri-implantitis were analyzed. Data on clinical characteristics prior to surgical therapy and at latest follow-up were obtained. In each radiograph, the marginal bone level was assessed at the mesial and distal aspects of the affected implants. The treatment included oral hygiene instruction, professional supra-mucosal instrumentation, and surgical therapy aiming at pocket elimination. Following flap elevation and removal of inflamed tissue, the affected implant was cleaned using gauze soaked in saline. Calculus was removed. When indicated, osseous re-contouring was carried out to facilitate pocket elimination. Flaps were adjusted, sutured, and compressed to the crestal bone. Supportive therapy including oral hygiene control was provided with 4-month intervals. RESULTS: Treatment was effective in resolving the inflammatory condition as documented by marked reduction in peri-implant probing depth and bleeding on probing scores together with crestal bone level preservation. Treatment outcome was significantly better at implants with non-modified surfaces than at implants with modified surfaces. The probability of an implant to exhibit no further bone loss or bone gain after treatment was high if the peri-implant mucosa at the site presented with shallow pockets and the absence of bleeding on probing at follow-up. CONCLUSIONS: The results of the study revealed that (i) surgical treatment of peri-implantitis was effective in the long-term, (ii) outcome was better at implants with non-modified than with modified surfaces, and (iii) preservation of crestal bone support was consistent with healthy peri-implant tissue conditions.
OBJECTIVE: To assess long-term clinical and radiological outcomes of surgical treatment of peri-implantitis. MATERIAL AND METHODS: Files and radiographs from 50 patients who had received surgical treatment for peri-implantitis were analyzed. Data on clinical characteristics prior to surgical therapy and at latest follow-up were obtained. In each radiograph, the marginal bone level was assessed at the mesial and distal aspects of the affected implants. The treatment included oral hygiene instruction, professional supra-mucosal instrumentation, and surgical therapy aiming at pocket elimination. Following flap elevation and removal of inflamed tissue, the affected implant was cleaned using gauze soaked in saline. Calculus was removed. When indicated, osseous re-contouring was carried out to facilitate pocket elimination. Flaps were adjusted, sutured, and compressed to the crestal bone. Supportive therapy including oral hygiene control was provided with 4-month intervals. RESULTS: Treatment was effective in resolving the inflammatory condition as documented by marked reduction in peri-implant probing depth and bleeding on probing scores together with crestal bone level preservation. Treatment outcome was significantly better at implants with non-modified surfaces than at implants with modified surfaces. The probability of an implant to exhibit no further bone loss or bone gain after treatment was high if the peri-implant mucosa at the site presented with shallow pockets and the absence of bleeding on probing at follow-up. CONCLUSIONS: The results of the study revealed that (i) surgical treatment of peri-implantitis was effective in the long-term, (ii) outcome was better at implants with non-modified than with modified surfaces, and (iii) preservation of crestal bone support was consistent with healthy peri-implant tissue conditions.
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