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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.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.

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

Explantation of dental implant.
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fig3: Explantation of dental implant.

Mentions: Systemic antibiotics as adjunct to peri-implant flap surgery treatment are commonly used. Heitz-Mayfield and coworkers [82] have recently reported on a prospective clinical trial of thirty-six implants in 24 partially dentate patients with moderate to advanced peri-implantitis that were treated using an anti-infective surgical protocol incorporating open flap debridement and implant surface decontamination, with adjunctive systemic amoxicillin and metronidazole. At twelve months, mean pocket reduction was 2.6 mm with all treated implants having a mean PD < 5 mm. 47% of the implants had complete resolution of inflammation with no bleeding on probing. 92% of implants had stable crestal bone levels or bone gain. There were no significant effects of smoking on any of the treatment outcomes. Leonhardt et al. [83] reported on a five-year clinical, microbiological, and radiological study into the treatment of peri-implantitis. Surgical exposure of the lesions and cleaning of the implants were performed using hydrogen peroxide. The patients were than given systemic antibiotics according to a susceptibility test of target bacteria that were previously cultured. The treatment was evaluated clinically, microbiologically, and radiographically at 6 months, 1 year, and 5 years. Seven out of 26 implants with peri-implantitis at baseline were lost during the 5-year follow-up period despite a significant reduction in the presence of plaque and gingival bleeding. Four implants continued to lose bone, 9 had an unchanged bone level, and 6 gained bone. Five of the patients were treated with antibiotics directed against putative periodontopathogens, that is, A. actinomycetemcomitans, P. intermedia, or P. gingivalis; three patients were treated for presence of enterics (E. coli and E. cloacae); and, in one patient, treatment was directed against S. aureus.


Treatment Alternatives to Negotiate Peri-Implantitis.

Machtei EE - Adv Med (2014)

Explantation of dental implant.
© Copyright Policy
Related In: Results  -  Collection

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

fig3: Explantation of dental implant.
Mentions: Systemic antibiotics as adjunct to peri-implant flap surgery treatment are commonly used. Heitz-Mayfield and coworkers [82] have recently reported on a prospective clinical trial of thirty-six implants in 24 partially dentate patients with moderate to advanced peri-implantitis that were treated using an anti-infective surgical protocol incorporating open flap debridement and implant surface decontamination, with adjunctive systemic amoxicillin and metronidazole. At twelve months, mean pocket reduction was 2.6 mm with all treated implants having a mean PD < 5 mm. 47% of the implants had complete resolution of inflammation with no bleeding on probing. 92% of implants had stable crestal bone levels or bone gain. There were no significant effects of smoking on any of the treatment outcomes. Leonhardt et al. [83] reported on a five-year clinical, microbiological, and radiological study into the treatment of peri-implantitis. Surgical exposure of the lesions and cleaning of the implants were performed using hydrogen peroxide. The patients were than given systemic antibiotics according to a susceptibility test of target bacteria that were previously cultured. The treatment was evaluated clinically, microbiologically, and radiographically at 6 months, 1 year, and 5 years. Seven out of 26 implants with peri-implantitis at baseline were lost during the 5-year follow-up period despite a significant reduction in the presence of plaque and gingival bleeding. Four implants continued to lose bone, 9 had an unchanged bone level, and 6 gained bone. Five of the patients were treated with antibiotics directed against putative periodontopathogens, that is, A. actinomycetemcomitans, P. intermedia, or P. gingivalis; three patients were treated for presence of enterics (E. coli and E. cloacae); and, in one patient, treatment was directed against S. aureus.

Bottom Line: Surgical therapy is aimed at removing any residual subgingival deposits and additionally reducing the peri-implant pockets depth.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.

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