Search

Objectives: The aim of the present prospective study was to assess the risk for disease recurrence following surgical therapy of peri‐implantitis. Material & Methods: 73 patients (130 implants) treated surgically for peri‐implantitis were examined at 1 and 5 years after therapy. The primary outcome was recurrence/progression of disease defined as any of the following events: (a) bone loss >1.0 mm, (b) surgical retreatment, (c) implant removal/loss after year 1. Patient‐ and implant‐related parameters as well as 1‐year outcomes were evaluated as potential predictors through multiple logistic regression analysis. Results: 57 implants (44%) displayed recurrence/progression of peri‐implantitis during follow‐up. Among these, 27 implants were removed. Residual deep probing pocket depth (≥6 mm; odds ratio 7.4; 95% confidence interval 2.8–19.3) and reduced marginal bone level (OR 1.4; 95%CI 1.1–1.7) at 1 year after surgery constituted risk factors for recurrence/progression of disease. Furthermore, implants with modified surfaces were at higher risk than implants with non‐modified surfaces (OR 5.1; 95%CI 1.6–16.5). Conclusion: Implants with (a) residual deep probing pocket depth, (b) reduced marginal bone level, or (c) modified surfaces following surgical therapy of peri‐implantitis present with increased risk for recurrence/progression. [ABSTRACT FROM AUTHOR]

Objective: To examine the progression of experimental peri‐implantitis around different implants placed in augmented and pristine sites. Materials and Methods: Six labrador dogs were used. Three months after tooth extraction, four implants with different surface modifications were installed on each side of the mandible. A standard osteotomy was applied on one side, while on the contralateral side the osteotomy was modified, resulting in a gap between the implant and the bone wall. The gap was filled with a bone substitute and covered by a resorbable membrane. Three months after implant installation, implants were exposed and healing abutments were connected. Two months later, oral hygiene procedures were abandoned and a cotton ligature was placed in a submarginal position around the neck of all implants and kept in place for 4 weeks. Following ligature removal, plaque formation continued for 6 months (spontaneous progression period). Radiographs were obtained throughout the experiment, and biopsies were collected and prepared for histological evaluation at the end of the spontaneous progression period. Results: Differences in bone loss during the spontaneous progression period between pristine and augmented sites were small. The size and vertical dimension of the peri‐implantitis lesion were larger at augmented than at pristine sites. Implants with non‐modified surfaces exhibited smaller amounts of bone loss and smaller dimensions of peri‐implantitis lesions than implants with modified surfaces. Conclusion: Small differences in spontaneous progression of peri‐implantitis were detected between pristine and augmented sites. Implants with modified surfaces exhibited more bone loss and larger lesions than implants with non‐modified surfaces, irrespective of the type of surrounding bone. [ABSTRACT FROM AUTHOR]

Objectives This study reports on the 3-year follow-up of patients enrolled in a randomized controlled clinical trial on surgical treatment of advanced peri-implantitis. Material and Methods A total of 100 patients with advanced peri-implantitis were randomly assigned to one of four treatment groups. Surgical therapy aiming at pocket elimination was performed and, in three test groups, supplemented by either systemic antibiotics, use of an antiseptic agent for implant surface decontamination or both. Outcomes were evaluated after 1 and 3 years by means of clinical and radiological examinations. Differences between groups were explored by regression analysis. Results Clinical examinations at 3 years after treatment revealed (i) improved peri-implant soft tissue health with a mean reduction in probing depth of 2.7 mm and a reduction in bleeding/suppuration on probing of 40% and (ii) stable peri-implant marginal bone levels (mean bone loss during follow-up: 0.04 mm). Implant surface characteristics had a significant impact on 3-year outcomes, in favour of implants with non-modified surfaces. Benefits of systemic antibiotics were limited to implants with modified surfaces and to the first year of follow-up. Conclusion It is suggested that surgical treatment of peri-implantitis is effective and that outcomes of therapy are affected by implant surface characteristics. Potential benefits of systemic antibiotics are not sustained over 3 years. [ABSTRACT FROM AUTHOR]

Aim To evaluate the effect of surgical treatment of experimental peri-implantitis at implants with different surface characteristics using different anti-infective procedures. Material and methods Four implants with different surface characteristics (A: TiOblast, B: OsseoSpeed, C: AT-I, D: TiUnite) were installed in a randomized order in each side of the mandible in 6 labrador dogs 3 months after tooth extraction. Experimental peri-implantitis was induced 3 months later. Surgical treatment of peri-implantitis was performed. The implants were cleaned with gauze soaked in either saline (control) or chlorhexidine (test). Clinical and radiographical examinations were performed and microbiological samples were taken during a 6-month period after surgery. Biopsies were obtained and prepared for histological analysis. Results Clinical signs of soft tissue inflammation were reduced after surgical therapy in most test and control sites. While the analysis of bone level alterations in radiographs together with histological and microbiological assessments of resolution of peri-implantitis lesions failed to demonstrate statistically significant differences between test and control procedures, the evaluations disclosed significant differences between implant D and implants A, B and C on treatment outcome. Conclusion It is suggested that (i) the local use of chlorhexidine has minor influence on treatment outcome, (ii) resolution of peri-implantitis following surgical treatment without the adjunctive use of local and systemic antimicrobial agents is possible and (iii) the results are influenced by implant surface characteristics. [ABSTRACT FROM AUTHOR]

Aim To analyze the tissue reactions following ligature removal in experimental periodontitis and peri-implantitis in dogs. Material and methods Four implants with similar geometry and with two different surface characteristics (turned/TiUnite Nobel BioCare AB, Göteborg) were placed pair-wise in a randomized order in the right side of the mandible 3 months after tooth extraction in 5 dogs. Experimental peri-implantitis and periodontitis were initiated 3 months later by ligature placement around implants and mandibular premolars and plaque formation. The ligatures were removed after 10 weeks, and block biopsies were obtained and prepared for histological analysis 6 months later. Results It was demonstrated that the amount of bone loss that occurred during the period following ligature removal was significantly larger at implants with a modified surface than at implants with a turned surface and at teeth. The histological analysis revealed that peri-implantitis sites exhibited inflammatory cell infiltrates that were larger, extended closer to the bone crest and contained larger proportions of neutrophil granulocytes and osteoclasts than in periodontitis. Conclusion It is suggested that lesions produced in experimental periodontitis, and peri-implantitis are different and that implant surface characteristics influence the inflammatory process in experimental peri-implantitis and the magnitude of the resulting tissue destruction. [ABSTRACT FROM AUTHOR]