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Treatment Alternatives to Negotiate Peri-Implantitis.

Machtei EE - Adv Med (2014)

Bottom Line: Surgical therapy is aimed at removing any residual subgingival deposits and additionally reducing the peri-implant pockets depth.The available literature is still lacking with large heterogeneity in the clinical response thus suggesting possible underlying predisposing conditions that are not all clear to us.Therefore, at present time treatment of peri-implantitis should be considered possible but not necessarily predictable.

View Article: PubMed Central - PubMed

Affiliation: Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus and Faculty of Medicine, Technion (Israel Institute of Technology), Rambam HCC, 8 Ha'alia Hashnia Street, 31096 Haifa, Israel.

ABSTRACT
Peri-implant diseases are becoming a major health issue in dentistry. Despite the magnitude of this problem and the potential grave consequences, commonly acceptable treatment protocols are missing. Hence, the present paper reviews the literature treatment of peri-implantitis in order to explore their benefits and limitations. Treatment of peri-implantitis may include surgical and nonsurgical approaches, either individually or combined. Nonsurgical therapy is aimed at removing local irritants from the implants' surface with or without surface decontamination and possibly some additional adjunctive therapies agents or devices. Systemic antibiotics may also be incorporated. Surgical therapy is aimed at removing any residual subgingival deposits and additionally reducing the peri-implant pockets depth. This can be done alone or in conjunction with either osseous respective approach or regenerative approach. Finally, if all fails, explantation might be the best alternative in order to arrest the destruction of the osseous structure around the implant, thus preserving whatever is left in this site for future reconstruction. The available literature is still lacking with large heterogeneity in the clinical response thus suggesting possible underlying predisposing conditions that are not all clear to us. Therefore, at present time treatment of peri-implantitis should be considered possible but not necessarily predictable.

No MeSH data available.


Related in: MedlinePlus

Treatment of peri-implantitis using a regenerative approach. (a) Preop, note the severe bone loss on implant at position #14. (b) Upon reflection of the flaps, note the granulation tissue but also excess cementum on the crown's margin. (c) Following degranulation, demonstrating the extent of bone loss. (d) Excess cement was removed and the implant surface was debrided using hand instruments and ultrasonic scaler. (e) Decortication was performed using diamond burs. (f) Surface decontamination was supplemented with the application of 24% EDTA for 3 minutes. (g) The defect was grafted with bovine derived Xenograft (BioOss). (h) 3 years later, complete resolution of the radiographic defect is evident.
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fig2: Treatment of peri-implantitis using a regenerative approach. (a) Preop, note the severe bone loss on implant at position #14. (b) Upon reflection of the flaps, note the granulation tissue but also excess cementum on the crown's margin. (c) Following degranulation, demonstrating the extent of bone loss. (d) Excess cement was removed and the implant surface was debrided using hand instruments and ultrasonic scaler. (e) Decortication was performed using diamond burs. (f) Surface decontamination was supplemented with the application of 24% EDTA for 3 minutes. (g) The defect was grafted with bovine derived Xenograft (BioOss). (h) 3 years later, complete resolution of the radiographic defect is evident.

Mentions: Serino and Turri [57] reported on their two-year prospective clinical trial of thirty-one subjects (86 implants) treated for peri-implantitis using a surgical procedure based on pocket elimination and bone recontouring. Two years following treatment, 15 (48%) subjects had no signs of recurrent peri-implant disease; 24 patients (77%) had no implants with a probing pocket depth of 0.6 mm associated with bleeding and/or suppuration following probing. Nevertheless, 36 implants (42%) out of the original 86 had had persistent peri-implant disease despite this treatment. The proportion of implants that remained healthy following treatment was higher for those with minor initial bone loss (2–4 mm bone loss as assessed during surgery) compared with the implants with an initial bone loss of 0.5 mm (74% versus 40%). Among the eighteen implants with bone loss of 0.7 mm at baseline, seven were explanted.


Treatment Alternatives to Negotiate Peri-Implantitis.

Machtei EE - Adv Med (2014)

Treatment of peri-implantitis using a regenerative approach. (a) Preop, note the severe bone loss on implant at position #14. (b) Upon reflection of the flaps, note the granulation tissue but also excess cementum on the crown's margin. (c) Following degranulation, demonstrating the extent of bone loss. (d) Excess cement was removed and the implant surface was debrided using hand instruments and ultrasonic scaler. (e) Decortication was performed using diamond burs. (f) Surface decontamination was supplemented with the application of 24% EDTA for 3 minutes. (g) The defect was grafted with bovine derived Xenograft (BioOss). (h) 3 years later, complete resolution of the radiographic defect is evident.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4590969&req=5

fig2: Treatment of peri-implantitis using a regenerative approach. (a) Preop, note the severe bone loss on implant at position #14. (b) Upon reflection of the flaps, note the granulation tissue but also excess cementum on the crown's margin. (c) Following degranulation, demonstrating the extent of bone loss. (d) Excess cement was removed and the implant surface was debrided using hand instruments and ultrasonic scaler. (e) Decortication was performed using diamond burs. (f) Surface decontamination was supplemented with the application of 24% EDTA for 3 minutes. (g) The defect was grafted with bovine derived Xenograft (BioOss). (h) 3 years later, complete resolution of the radiographic defect is evident.
Mentions: Serino and Turri [57] reported on their two-year prospective clinical trial of thirty-one subjects (86 implants) treated for peri-implantitis using a surgical procedure based on pocket elimination and bone recontouring. Two years following treatment, 15 (48%) subjects had no signs of recurrent peri-implant disease; 24 patients (77%) had no implants with a probing pocket depth of 0.6 mm associated with bleeding and/or suppuration following probing. Nevertheless, 36 implants (42%) out of the original 86 had had persistent peri-implant disease despite this treatment. The proportion of implants that remained healthy following treatment was higher for those with minor initial bone loss (2–4 mm bone loss as assessed during surgery) compared with the implants with an initial bone loss of 0.5 mm (74% versus 40%). Among the eighteen implants with bone loss of 0.7 mm at baseline, seven were explanted.

Bottom Line: Surgical therapy is aimed at removing any residual subgingival deposits and additionally reducing the peri-implant pockets depth.The available literature is still lacking with large heterogeneity in the clinical response thus suggesting possible underlying predisposing conditions that are not all clear to us.Therefore, at present time treatment of peri-implantitis should be considered possible but not necessarily predictable.

View Article: PubMed Central - PubMed

Affiliation: Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus and Faculty of Medicine, Technion (Israel Institute of Technology), Rambam HCC, 8 Ha'alia Hashnia Street, 31096 Haifa, Israel.

ABSTRACT
Peri-implant diseases are becoming a major health issue in dentistry. Despite the magnitude of this problem and the potential grave consequences, commonly acceptable treatment protocols are missing. Hence, the present paper reviews the literature treatment of peri-implantitis in order to explore their benefits and limitations. Treatment of peri-implantitis may include surgical and nonsurgical approaches, either individually or combined. Nonsurgical therapy is aimed at removing local irritants from the implants' surface with or without surface decontamination and possibly some additional adjunctive therapies agents or devices. Systemic antibiotics may also be incorporated. Surgical therapy is aimed at removing any residual subgingival deposits and additionally reducing the peri-implant pockets depth. This can be done alone or in conjunction with either osseous respective approach or regenerative approach. Finally, if all fails, explantation might be the best alternative in order to arrest the destruction of the osseous structure around the implant, thus preserving whatever is left in this site for future reconstruction. The available literature is still lacking with large heterogeneity in the clinical response thus suggesting possible underlying predisposing conditions that are not all clear to us. Therefore, at present time treatment of peri-implantitis should be considered possible but not necessarily predictable.

No MeSH data available.


Related in: MedlinePlus