Mercado F, Ivanovski S.
Objective: Comparative biology of chronic and aggressive periodontitis vs. peri-implantitis notes there are similarities but also differences, particularly regarding the rapid progression of peri-implantitis when compared to periodontitis (Heitz-Mayfield L, Lang N 2010). This highlights the need for a surgical approach at its earlier stages of bone loss. However, experimental and clinical studies show no reliable regenerative treatment of peri-implantitis. The current study aimed to examine the regenerative capacity of xenograft and enamel matrix derivatives in the management of peri-implantitis clinically.
Method: Peri-implantitis found at 12 patients referred by dentists were treated. The patients were systemically healthy and non-smokers. The patients gave written consent to the treatment after explanation of the protocol. The measurements obtained were probing depths, recession and radiographic bone fill. The minimal probing depth requirement and initial bone loss were 4mm and 20%. The presence of gingival inflammation, bleeding on probing and suppuration were also noted. The implants were debrided using mild-ultrasonic power. The implant surfaces were decontaminated with a saline EDTA solution used in the enamel matrix derivative preparation. The defects were filled with the cocktail of materials. The materials used were Bio-Oss, Bio-Gide, Emdogain and doxycycline powder. The defects were covered with a resorbable membrane.
Result: An average probing depth reduction of 4 mm was noted on all the implants. There is no difference in the clinical parameters at 6 and 16 months. The average bone fill was 80%, with three cases having 90-100% bone fill. The clinical symptoms of peri-implantitis such as gingival inflammation and bleeding on probing also improved.
Conclusion: The result of this regenerative treatment of peri-implantitis appears to be promising. More cases done in multi-center practices are needed to measure the predictability of this protocol.