title: Porous titanium granules in the surgical treatment of peri-implant osseous defects: a randomized clinical trial.
abstract: OBJECTIVE
  Porous titanium granules (PTG) may have potential as an osteoconductive bone graft substitute to treat peri-implant osseous defects. The aim of this study was to analyze clinical and radiographic outcomes of peri-implant osseous defects after treatment with PTG.
  
  
  METHODS
  This prospective, randomized, case-control, clinical 12-month study compared open-flap debridement and surface decontamination with titanium curettes and 24% ethylenediaminetetraacetic acid gel (n = 16) to the same protocol but with the addition of PTG (n = 16). One-, two-, and three-wall infrabony defects were included. Patients were given amoxicillin and metronidazole 3 days before surgery and for 7 days afterwards. Implants were submerged and allowed to heal for 6 months. Probing pocket depths, bleeding on probing, implant stability using resonance frequency analysis, and radiographic evaluation were performed at baseline and at 12 months. The threshold for significance was set at .05.
  
  
  RESULTS
  Change in radiographic defect height and percent fill of the peri-implant osseous defect significantly favored patients treated with PTG. Both treatment modalities demonstrated significant improvements in probing pocket depth, but significant differences between groups were not observed. The PTG-treated implants showed an increase in implant stability quotient (ISQ) of 1.6 units, compared with a decrease of 0.7 ISQ for the control group. No adverse effects were associated with PTG treatment.
  
  
  CONCLUSIONS
  Reconstruction with PTG resulted in significantly better radiographic peri-implant defect fill compared with controls; however, the results do not necessarily imply reosseointegration or osseointegration of PTG particles. Improvements in clinical parameters were seen in both groups, but no differences between groups were demonstrated.
authors.affiliation: Department of Biomaterials, University of Oslo, Oslo, Norway. johancw@odont.uio.no
authors.forename: Johan Caspar
authors.initials: JC
authors.lastname: Wohlfahrt
authors.forename: Ståle Petter
authors.initials: SP
authors.lastname: Lyngstadaas
authors.forename: Hans Jacob
authors.initials: HJ
authors.lastname: Rønold
authors.forename: Erik
authors.initials: E
authors.lastname: Saxegaard
authors.forename: Jan Eirik
authors.initials: JE
authors.lastname: Ellingsen
authors.forename: Stig
authors.initials: S
authors.lastname: Karlsson
authors.forename: Anne Merete
authors.initials: AM
authors.lastname: Aass
mesh_terms: D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D018786:Bone Substitutes / Q000627:therapeutic use*; D016022:Case-Control Studies; D003475:Curettage / Q000379:methods; D003646:Debridement / Q000379:methods; D019551:Dental Disinfectants / Q000627:therapeutic use; D015921:Dental Implants; D017268:Dental Prosthesis Retention; D018450:Disease Progression; D004492:Edetic Acid / Q000627:therapeutic use; D005260:Female; D005884:Gingival Hemorrhage / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D016348:Osseointegration / Q000502:physiology; D057873:Peri-Implantitis / Q000601:surgery*; D010514:Periodontal Pocket / Q000601:surgery; D016062:Porosity; D011446:Prospective Studies; D013524:Surgical Flaps; D014025:Titanium / Q000627:therapeutic use*; D016896:Treatment Outcome; D014732:Vibration
chemical_list: D018786:Bone Substitutes; D019551:Dental Disinfectants; D015921:Dental Implants; D004492:Edetic Acid; D014025:Titanium