Treatment of peri-implantitis: description of a Technique of surgical detoxification of the implant. a prospective clinical case series with 3-year follow-up

Abstract

Objective. This prospective clinical case series on peri-implantitis therapy reports on clinical and radiographic changes occurring after the use of an innovative technique of surgical degranulation combined with a thorough detoxification of the implant and local antibiotics application.
Methods. In 14 partially edentulous patients, 18 implants diagnosed with peri-implantitis were treated. Implant detoxification was performed mechanically and chemically with citric acid at pH 1. Thereafter, tetracycline powder and chlorexidine gel by way of a collagen sponge carrier were applied on the implant surface, filling the bone defect. Neither resective nor regenerative surgery were performed. Clinical and radiographic parameters were recorded prior to and three years after treatment.
Results. Clinical parameters improved after three years observation period. A statistically significant (p<0.001) reduction of probing pocket depth (PPD) was found. Bone recovery was 35% in respect to baseline (prosthesis loading). The bone variation expressed in millimetres at time of surgical treatment and 3-year follow up was statistically significant (p<0.001). No implant was lost in the observation period.
Conclusion. Surgical degranulation combined with mechanical and chemical detoxification of the implant and local antibiotic therapy seems to be a reliable method for stopping and controlling peri-implantitis.