Attempts to obtain re-osseointegration following experimental peri-implantitis in dogs.
The purpose of this study was to examine the healing potential and re-osseointegration in peri-implant infection defects adjacent to various implant surfaces. In 7 female Beagle dogs, a total of 41 titanium oral implants (ITI, Straumann, Waldenburg; Switzerland) with a sink depth of 6 mm (diameter 2.8 mm) were placed transmucosally. Four different surface configurations (TPS: titanium plasma sprayed (10); SLA: sand blasted and acid-etched (13); M: machined and smooth (11); TPS furc.: titanium plasma sprayed with coronally placed perforation to mimic a furcation (7) were distributed among the animals and locations. Following a healing period of 3 months, silk ligatures were placed and oral cleaning procedures abolished for 4 months to induce a vertical bone loss of about 40%. Following mechanical and chemical cleansing (chlorhexidine and metronidazole) and disinfection, the lesions were either sham operated (11) or subjected to a GTR procedure using ePTFE (30). After 6 months of healing the animals were killed and the jaws histologically evaluated. Six membranes were lost TPS: (1); SLA: (2); M: (2); TPS furc: (1) and 3 membranes exposed TPS: (1); M: (2) and excluded from further evaluation. Owing to the loss of 1 implant and infection of the membranes in the TPS furc group, this implant configuration was discarded from further analysis. For TPS surfaces, bone fill was 2.6 mm (73% of the distance from the bottom of the defect to the shoulder of the implant) sites with (4 GTR) and 0.33 mm (14%) for sites without membrane (2 controls). Re-osseointegration was 0.5 mm (14%) in the test group and 0.3 mm (14%) in the control. For SLA surfaces bone fill was 2.3 mm (83%) for sites with (7 GTR) and 0.41 mm (15%) for sites without membranes (4 controls). Re-osseointegration was 0.6 mm (20%) and 0.3 mm (11%) respectively. Corresponding values for M surfaces were 2.2 mm (62%) with 4 GTR) and 0.82 mm (31%) without membranes. Re-osseointegration was 0.07 mm (2%) and 0.19 mm (7%) respectively. This study has documented that peri-implant infections defects may heal with bone fill provided that the infection is controlled through effective antibacterial therapy. However, true reosseointegration appears to be difficult to achieve.
Wetzel
A C
AC
University of Berne, Switzerland.
Vlassis
J
J
Caffesse
R G
RG
Hämmerle
C H
CH
Lang
N P
NP
D000539:Alveolar Process / Q000502:physiology; D000818:Animals; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001861:Bone Regeneration; D002710:Chlorhexidine / Q000627:therapeutic use; D015921:Dental Implants / Q000009:adverse effects*; D003773:Dental Plaque / Q000150:complications; D017267:Dental Prosthesis Design; D004285:Dogs; D005260:Female; D016557:Guided Tissue Regeneration, Periodontal; D008567:Membranes, Artificial; D008795:Metronidazole / Q000627:therapeutic use; D016348:Osseointegration; D010518:Periodontitis / Q000209:etiology* / Q000628:therapy; D011138:Polytetrafluoroethylene; D016459:Prosthesis-Related Infections / Q000188:drug therapy* / Q000209:etiology; D019233:Retreatment; D018709:Statistics, Nonparametric; D014945:Wound Healing
D000890:Anti-Infective Agents; D015921:Dental Implants; D008567:Membranes, Artificial; D008795:Metronidazole; D011138:Polytetrafluoroethylene; D002710:Chlorhexidine