Peri-implant Treatment Modalities and Outcomes

Objectives: Peri-implantitis is an infectious condition of the tissues around osseointegrated implants with loss of supporting bone and clinical signs of inflammation. The purpose of this study was to determine the prevalence of peri-implant tissue breakdown within a specific institutional patient population. In addition, treatment modalities applied to treat peri-implantitis and the short- and long-term outcomes of such treatments were investigated.
Methods: A retrospective study design was used. OSU College of Dentistry patients diagnosed with peri-implant disease following at least 6 months of loading and the treatment modalities applied to treat this disease were screened by using the college computer system patient records. The maintenance of implant supported dental restorations through these treatments was documented. Surgical treatment modalities and complications were determined by screening individual patient charts.
Results: 20 cases (65±2 yrs; 11 female) with documented peri-implantitis surgical treatment were identified from a total of 485 patients treated with screw-type dental implants (4%). All implants were restored as single crowns with most of them localized at posterior sextants (11 maxillary and 8 mandibular sites). Mean loading time prior to peri-implantitis treatment was 55±9 months (median: 49 [4-94] months). Explantation, due to implant loosening, was performed in one case (5% of peri-implantitis cases). Applied surgical treatment modalities included GBR (15 cases), osseous surgery (1 case) and flap only (4 cases). A common post-operative complication was wound opening and related graft exposure (12 cases). Following surgical treatment, no implants were explanted (postoperative observation period: 3-24 months).
Conclusions: Within the limits of this study, the prevalence of peri-implantitis in an institutional setting is low. Although various treatment options can be used to treat peri-implantitis and appear to stabilize tissue integrity, prospective studies are needed to determine short and long-term outcomes.