Five-year clinical, microbiological, and radiological outcome following treatment of peri-implantitis in man.
BACKGROUND
The aim of this study was to evaluate the long-term outcome of a combined surgical and antimicrobial treatment of peri-implantitis lesions in humans.


METHODS
Nine partially dentate individuals with titanium implants demonstrating a marginal bone loss of > or = three threads as compared to baseline measurements made from 1-year intra-oral radiographs, bleeding on probing, and/or suppuration from the peri-implant sulci were included in the study. In each individual, subgingival bacterial samples were obtained and subjected to microbiological analysis by culture. Surgical exposure of the lesions and cleaning of the implants using hydrogen peroxide were performed. The patients were given systemic antibiotics according to a susceptibility test of target bacteria. The treatment was evaluated clinically, microbiologically, and radiograpically at 6 months, 1 year, and 5 years.


RESULTS
Seven out of 26 implants with peri-implantitis at baseline were lost during the 5-year follow-up period despite a significant reduction in the presence of plaque and gingival bleeding. Four implants continued to lose bone, 9 had an unchanged bone level, and 6 gained bone. Five of the patients were treated with antibiotics directed against putative periodontopathogens, i.e., A. actinomycetemcomitans, P. intermedia, or P. gingivalis; three patients were treated for presence of enterics (E. coli and E. cloace); and, in one patient, treatment was directed against S. aureus.


CONCLUSIONS
Despite treatment and retreatment, seven implants were lost. However, the applied surgical and antimicrobial treatment strategy for advanced peri-implantitis lesions was successful in 58% of the implants treated during the 5-year follow-up period. Smoking seemed to be a negative risk factor for treatment success.
Leonhardt
Asa
A
Department of Periodontology, Specialist Dental Clinic, Mölndal Hospital, Mölndal, Sweden. asa.leonhardt@vgregion.se
Dahlén
Gunnar
G
Renvert
Stefan
S
D000368:Aged; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology / Q000382:microbiology* / Q000628:therapy*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D015169:Colony Count, Microbial; D003758:Dental Implantation, Endosseous / Q000009:adverse effects; D015921:Dental Implants / Q000009:adverse effects*; D019232:Dental Restoration Failure; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010518:Periodontitis / Q000000981:diagnostic imaging / Q000209:etiology / Q000382:microbiology* / Q000628:therapy*; D011859:Radiography; D012907:Smoking / Q000009:adverse effects; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D015921:Dental Implants