title: Clinical and radiographic outcomes of a combined resective and regenerative approach in the treatment of peri-implantitis: a prospective case series.
abstract: OBJECTIVE
  To assess the clinical and radiographic outcomes applying a combined resective and regenerative approach in the treatment of peri-implantitis.
  
  
  METHODS
  Subjects with implants diagnosed with peri-implantitis (i.e., pocket probing depth (PPD) ≥5 mm with concomitant bleeding on probing (BoP) and ≥2 mm of marginal bone loss or exposure of ≥1 implant thread) were treated by means of a combined approach including the application of a deproteinized bovine bone mineral and a collagen membrane in the intrabony and implantoplasty in the suprabony component of the peri-implant lesion, respectively. The soft tissues were apically repositioned allowing for a non-submerged healing. Clinical and radiographic parameters were evaluated at baseline and 12 months after treatment.
  
  
  RESULTS
  Eleven subjects with 11 implants were treated and completed the 12-month follow-up. No implant was lost yielding a 100% survival rate. At baseline, the mean PPD and mean clinical attachment level (CAL) were 8.1 ± 1.8 mm and 9.7 ± 2.5 mm, respectively. After 1 year, a mean PPD of 4.0 ± 1.3 mm and a mean CAL of 6.7 ± 2.5 mm were assessed. The differences between the baseline and the follow-up examinations were statistically significant (P = 0.001). The mucosal recession increased from 1.7 ± 1.5 at baseline to 3.0 ± 1.8 mm at the 12-month follow-up (P = 0.003). The mean% of sites with BoP+ around the selected implants decreased from 19.7 ± 40.1 at baseline to 6.1 ± 24.0 after 12 months (P = 0.032). The radiographic marginal bone level decreased from 8.0 ± 3.7 mm at baseline to 5.2 ± 2.2 mm at the 12-month follow-up (P = 0.000001). The radiographic fill of the intrabony component of the defect amounted to 93.3 ± 13.0%.
  
  
  CONCLUSIONS
  Within the limits of this study, a combined regenerative and resective approach for the treatment of peri-implant defects yielded positive outcomes in terms of PPD reduction and radiographic defect fill after 12 months.
authors: Department of Periodontology, University Federico II, Naples, Italy.
authors: Sergio
authors: S
authors: Matarasso
authors: Vincenzo
authors: V
authors: Iorio Siciliano
authors: Marco
authors: M
authors: Aglietta
authors: Gianmaria
authors: G
authors: Andreuccetti
authors: Giovanni E
authors: GE
authors: Salvi
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003094:Collagen / Q000627:therapeutic use; D003762:Dental Instruments; D003774:Dental Plaque Index; D005260:Female; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D007558:Italy; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use; D057873:Peri-Implantitis / Q000000981:diagnostic imaging* / Q000628:therapy*; D010512:Periodontal Index; D011446:Prospective Studies; D011859:Radiography; D013524:Surgical Flaps
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; C077540:Bio-Oss; D008903:Minerals; D003094:Collagen; D007052:Ibuprofen
keywords: bone loss; bone substitutes; dental implants; guided bone regeneration; peri-implantitis; periodontitis; transmucosal healing