title: Impact of the method of surface debridement and decontamination on the clinical outcome following combined surgical therapy of peri-implantitis: a randomized controlled clinical study.
abstract: OBJECTIVE
  The study aimed at investigating the impact of two surface debridement/decontamination (DD) methods on the clinical outcomes of combined surgical treatment of peri-implantitis.
  
  
  METHODS
  Thirty-two patients suffering from advanced peri-implantitis (n=38 combined supra- and intra-bony defects) were treated with flap surgery, granulation tissue removal, and implantoplasty at buccally and supracrestally exposed implant parts. The intra-bony aspects were randomly allocated to surface DD using either (i) an Er:YAG laser (ERL) device, or (ii) plastic curets+cotton pellets+sterile saline (CPS). In both groups, the intra-bony component was augmented with a natural bone mineral and covered with a collagen membrane. Clinical and radiographic parameters were recorded at baseline and after 6 months of non-submerged healing.
  
  
  RESULTS
  Two patients were lost during follow-up. At 6 months, ERL-treated sites failed to reveal higher reductions in mean bleeding on probing (ERL: 47.8 ± 35.5 versus CPS: 55.0 ± 31.1%) and CAL values (ERL: 1.5 ± 1.4 versus CPS: 2.2 ± 1.4 mm) when compared with the CPS group. Both groups exhibited a comparable radiographic bone fill at the intra-bony defect component.
  
  
  CONCLUSIONS
  The study failed to demonstrate a significant impact of the method of surface DD on the clinical outcome following combined surgical therapy of advanced peri-implantitis lesions.
authors.affiliation: Department of Oral Surgery, Heinrich Heine University, Düsseldorf, Germany. frank.schwarz@med.uni-dueseldorf.de
authors.forename: Frank
authors.initials: F
authors.lastname: Schwarz
authors.forename: Narja
authors.initials: N
authors.lastname: Sahm
authors.forename: Gerhard
authors.initials: G
authors.lastname: Iglhaut
authors.forename: Jürgen
authors.initials: J
authors.lastname: Becker
mesh_terms: D016301:Alveolar Bone Loss / Q000601:surgery*; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D018786:Bone Substitutes / Q000627:therapeutic use; D002710:Chlorhexidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D003094:Collagen; D003475:Curettage / Q000295:instrumentation; D003646:Debridement; D015921:Dental Implants; D003774:Dental Plaque Index; D004203:Disinfection / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000601:surgery; D005889:Gingival Recession / Q000601:surgery; D006097:Granulation Tissue / Q000601:surgery; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000601:surgery; D010514:Periodontal Pocket / Q000601:surgery; D010518:Periodontitis / Q000601:surgery*; D012965:Sodium Chloride; D013499:Surface Properties; D013524:Surgical Flaps; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D018786:Bone Substitutes; D015921:Dental Implants; D008567:Membranes, Artificial; D012965:Sodium Chloride; D003094:Collagen; C010882:chlorhexidine gluconate; D002710:Chlorhexidine