OBJECTIVES In this study the effectiveness of implantoplasty was analyzed as a method of decontamination associated with regenerative therapy of peri-implantitis. Implantoplasty is a procedure that aim to make the implant portion exposed by the inflammatory process smooth by using decreasing abrasive burs mounted on rotating instruments. The goal of this procedure is to remove the superficial layer of titanium contaminated by bacteria and at the same time reduce the roughness of the implant body so as to make it less retentive of bacterial plaque, therefore less prone to recurrence. MATERIALS AND METHODS Five patients were selected aged between 50 and 77 years, for a total of 6 implants affected by peri-implantitis. The patients had been treated with implant rehabilitation in a period between 7 and 10 years before and all the im-plants had a rough surface. The peri-implant defects were of the intra-osseous type and were treated with regenerative therapy; the implant surface exposed by bone resorption was treated with implantoplasty. Before surgery, the patients underwent causal therapy with the use of teflon curettes, ultrasonic tip coated in plastic and simultaneous irrigation of chlorhexidine 0.2% mouthwash and the aid of an air-polish-ing tool and powder (erythritol, amorphous silica and 0,3% chlor-hexidine). Each patient was prescribed antibiotic therapy with amoxicillin and clavulanic acid or, in case of allergies, with clarithro-mycin. The surgical procedure consists in the preparation of a mucoperiosteal flap with vertical release incisions where necessary to reduce the flap tension, de-granulation of the peri-implant defect by means of teflon curettes and ultrasound tip and decontamination of the defect by use of 0.2% chlorhexidine washes. The implant portion that had lost sup-porting bone tissue was treated with implantoplasty as far as sur-gical access allowed, using dia-mond drills with decreasing gran-ulometry and polishing pads. Mi-croperforations of the bone marrow were performed in the intra-osseous defect, followed by the filling of the same with a het-erologous bone substitute based on deproteneized bovine bone (Bio-Oss®, Geistlich, Wolhusen, Switzerland) and subsequent placement of a resorbable collagen membrane. At 7 days the healing check and an intraoral radiograph was performed, and the sutures were removed at 14 days. All patients were included in a follow-up protocol that included 1, 3, 6 and 12 month control visits. RESULTS AND CONCLUSIONS The probing depths of the 6 implants recorded at the baseline (t0) in some cases exceeded 10 mm, and in 66.6% were >5 mm, with an average of 6.71±2.42 mm. At 6 months from the surgical treatment (t1) at none of the site a value of PD >5 mm was recorded, with an aver-age of 3.92±0.83 mm; BoP al-ways <25%. The intraoral radiographs showed a stable bone level compared to the post-surgical bone level; in addition, home oral hygiene was found to be improved in all patients. At 1 year from surgery (t2) the PD values recorded at each implant site were <5 mm with an average of 3.38±0.58 mm; no signs of inflammation were noticed and the intraoral radiographs showed no bone resorption. CLINICAL SIGNIFICANCE Despite the small number of the sample, and the impossibility to evaluate the peri-implant site histologically, implantoplasty associated with the regenerative treatment of peri-implantitis is a promising therapeutic approach.
|Translated title of the contribution||Implantoplasty associated with the regenerative treatment of peri-implantitis|
|Number of pages||8|
|Publication status||Published - May 1 2019|
ASJC Scopus subject areas
- Oral Surgery