Treatment of peri-implantitis using guided bone regeneration and bone grafts, alone or in combination, in beagle dogs. Part 1: Clinical findings and histologic observations.

The purpose of this study was to evaluate and compare the treatment of ligature-induced peri-implantitis using guided bone regeneration and two bone grafts alone and in combination. Mandibular premolars and first molars were extracted from four beagle dogs and after 3 months of healing, three Brånemark implants were placed on each side of the mandibles. Following abutment connection 3 months later, experimental peri-implantitis was induced by tying plaque-retentive ligatures around all abutments. Ligatures and abutments were removed after 3 months, and bony defects measured and treated with either: (1) debridement only; (2) debridement plus resorbable hydroxyapatite; (3) debridement plus canine freeze-dried demineralized bone; (4) debridement plus guided bone regeneration; (5) debridement plus resorbable hydroxyapatite and guided bone regeneration; or (6) debridement plus canine freeze-dried demineralized bone and guided bone regeneration. Pretreatment and 4-month-posttreatment comparison revealed a significant but variable degree of clinically appreciable hard tissue fill with all treatment procedures. Guided bone regeneration procedures resulted in the greatest fill, followed by bone grafts alone and flap debridement. There was no significant difference between guided bone regeneration and both guided bone regeneration/graft combinations; therefore, guided bone regeneration procedures appear to be a predictable treatment for plaque-induced peri-implant defects.