Management of extensive peri-implant defects with titanium meshes

Peri-implantitis is a biofilm-induced pathological condition, and different approaches have been proposed to manage this condition. This study introduces a surgical technique in accordance with the concept of guided bone regeneration for implants with extensive peri-implant defects. This pilot study was conducted on 7 patients with 11 implants (4 females and 3 males; 32 to 61 years). In this technique, we used a titanium mesh, a combination of autogenous bone, allogenic graft material, and acellular dermal matrix to reconstruct the peri-implant defects. All implants were placed submerged, and the second-stage surgery was conducted after 8 months. Soft tissue augmentation and vestibuloplasty were performed in the second-stage surgery, if required. The mean function time of implants was 60.5 ± 29.4 months. The mean baseline probing pocket depth was 5.7 ± 1.4 mm, and soft tissue recession was observed at two sites (18%). The mean recession and keratinized tissue width (KTW) values were 0.4 ± 0.8 mm and 3 ± 1.6 mm, respectively. The mean marginal bone loss and bone gain were 4.4 ± 1.2 mm and 2.9 ± 0.9 mm, respectively, which showed a significant improvement. Our preliminary evaluations showed favorable results in terms of radiographic defect fill and soft tissue condition. It appears that this technique may lead to promising outcomes in cautiously selected patients seeking to retain their failing implants. However, long-term results following functional loading are required before recommending this technique for daily practice.