Stability of Peri-implantitis Surgical Reconstructive Therapy-a (> 2 years) Follow-up of a Randomized Clinical Trial

Overview

Journal Clin Oral Investig

Specialty Dentistry

Date 2023 Dec 26

PMID 38147180

Authors

Chin-Wei Wang

Riccardo Di Gianfilippo

Niko Kaciroti

Alice Ou

Sheng-Wei Feng

Hom-Lay Wang

Affiliations

Soon will be listed here.

Abstract

Objectives: This follow-up study aimed to report the 24- and 30-month outcomes of a cohort previously enrolled in a randomized clinical trial on surgical reconstructive treatment of peri-implantitis.

Methods: Twenty-four patients were diagnosed with peri-implantitis and treated with surgical reconstructive therapy with or without the adjunctive use of Er:YAG laser. Within-group and between-group comparisons were tested with mixed model with repeated measures.

Results: Regarding peri-implant pocket depth (PPD) reduction (control vs. laser test group) between 6 months (- 1.85 vs. - 2.65 mm) and 30 months (- 1.84 vs. - 3.04 mm), the laser group showed statistically significant changes but not the control group. In terms of radiographic marginal bone loss (RMBL) at 6 months (- 1.1 vs. - 1.46 mm) to 24 months (- 1.96 vs. - 2.82 mm), both groups showed statistical difference compared to baseline. The six explanted implants all were featured by severe peri-implantitis and mostly with no or limited keratinized tissue (< 2 mm) at baseline and membrane exposure after surgery. Among the 15 retained cases, eight cases achieved more than 50% peri-implant bone level gain.

Conclusions: Within the limitation and follow-up time frame of this trial, the outcome of the surgical reconstructive therapy sustained or improved in most of the cases. However, 25% of the implants with severe peri-implantitis failed 2 years after the surgical reconstructive therapy. The use of Er:YAG laser favors PPD reduction in the longer term up to 30 months.

Clinical Relevance: Longer-term follow-up on reconstructive therapy of peri-implantitis revealed sustained or improved stability in certain cases, but the survival of implants with severe peri-implantitis has its limitation, especially when there is limited keratinized tissue (< 2 mm or no KT).

Trial Registration: Clinical Trials Registration Number: NCT03127228 and HUM00160290.

Citing Articles

Advancing Peri-Implantitis Treatment: A Scoping Review of Breakthroughs in Implantoplasty and Er:YAG Laser Therapies.

Mojaver S, Fiorellini J, Sarmiento H Clin Exp Dent Res. 2025; 11(1):e70104.

PMID: 40071719 PMC: 11898008. DOI: 10.1002/cre2.70104.

References

Derks J, Schaller D, Hakansson J, Wennstrom J, Tomasi C, Berglundh T . Effectiveness of Implant Therapy Analyzed in a Swedish Population: Prevalence of Peri-implantitis. J Dent Res. 2015; 95(1):43-9. DOI: 10.1177/0022034515608832. View

Chan H, Lin G, Suarez F, MacEachern M, Wang H . Surgical management of peri-implantitis: a systematic review and meta-analysis of treatment outcomes. J Periodontol. 2013; 85(8):1027-41. DOI: 10.1902/jop.2013.130563. View

Wang C, Renvert S, Wang H . Nonsurgical Treatment of Periimplantitis. Implant Dent. 2019; 28(2):155-160. DOI: 10.1097/ID.0000000000000846. View

Renvert S, Lindahl C, Persson G . Occurrence of cases with peri-implant mucositis or peri-implantitis in a 21-26 years follow-up study. J Clin Periodontol. 2017; 45(2):233-240. DOI: 10.1111/jcpe.12822. View

Carcuac O, Derks J, Abrahamsson I, Wennstrom J, Berglundh T . Risk for recurrence of disease following surgical therapy of peri-implantitis-A prospective longitudinal study. Clin Oral Implants Res. 2020; 31(11):1072-1077. DOI: 10.1111/clr.13653. View

Clem D, Gunsolley J . Peri-implantitis Treatment Using Er:YAG Laser and Bone Grafting. A Prospective Consecutive Case Series Evaluation: 1 Year Posttherapy. Int J Periodontics Restorative Dent. 2019; 39(4):479-489. DOI: 10.11607/prd.4158. View

Yamamoto A, Kubota T, Komatsu Y, Nohno K, Yasuda T, Takahashi T . Efficacy of Erbium:YAG Laser for Regenerative Surgical Treatment of Peri-implantitis: Clinical, Microbiological, and Biomarker Analyses. Int J Periodontics Restorative Dent. 2021; 41(2):187-192. DOI: 10.11607/prd.4071. View

Schwarz F, John G, Schmucker A, Sahm N, Becker J . Combined surgical therapy of advanced peri-implantitis evaluating two methods of surface decontamination: a 7-year follow-up observation. J Clin Periodontol. 2017; 44(3):337-342. DOI: 10.1111/jcpe.12648. View

Tomasi C, Regidor E, Ortiz-Vigon A, Derks J . Efficacy of reconstructive surgical therapy at peri-implantitis-related bone defects. A systematic review and meta-analysis. J Clin Periodontol. 2019; 46 Suppl 21:340-356. DOI: 10.1111/jcpe.13070. View

10.

Roccuzzo M, Layton D, Roccuzzo A, Heitz-Mayfield L . Clinical outcomes of peri-implantitis treatment and supportive care: A systematic review. Clin Oral Implants Res. 2018; 29 Suppl 16:331-350. DOI: 10.1111/clr.13287. View

11.

Zipprich H, Weigl P, Di Gianfilippo R, Steigmann L, Henrich D, Wang H . Comparison of decontamination efficacy of two electrolyte cleaning methods to diode laser, plasma, and air-abrasive devices. Clin Oral Investig. 2022; 26(6):4549-4558. DOI: 10.1007/s00784-022-04421-0. View

12.

Nevins M, Nevins M, Yamamoto A, Yoshino T, Ono Y, Wang C . Use of Er:YAG laser to decontaminate infected dental implant surface in preparation for reestablishment of bone-to-implant contact. Int J Periodontics Restorative Dent. 2014; 34(4):461-6. DOI: 10.11607/prd.2192. View

13.

Aoki A, Mizutani K, Schwarz F, Sculean A, Yukna R, Takasaki A . Periodontal and peri-implant wound healing following laser therapy. Periodontol 2000. 2015; 68(1):217-69. DOI: 10.1111/prd.12080. View

14.

Schwarz F, Sahm N, Iglhaut G, Becker J . Impact of the method of surface debridement and decontamination on the clinical outcome following combined surgical therapy of peri-implantitis: a randomized controlled clinical study. J Clin Periodontol. 2011; 38(3):276-84. DOI: 10.1111/j.1600-051X.2010.01690.x. View

15.

Schwarz F, John G, Mainusch S, Sahm N, Becker J . Combined surgical therapy of peri-implantitis evaluating two methods of surface debridement and decontamination. A two-year clinical follow up report. J Clin Periodontol. 2012; 39(8):789-97. DOI: 10.1111/j.1600-051X.2012.01867.x. View

16.

Wang C, Ashnagar S, Di Gianfilippo R, Arnett M, Kinney J, Wang H . Laser-assisted regenerative surgical therapy for peri-implantitis: A randomized controlled clinical trial. J Periodontol. 2020; 92(3):378-388. DOI: 10.1002/JPER.20-0040. View

17.

Pfefferbaum B, North C . Mental Health and the Covid-19 Pandemic. N Engl J Med. 2020; 383(6):510-512. DOI: 10.1056/NEJMp2008017. View

18.

Ravida A, Siqueira R, Di Gianfilippo R, Kaur G, Giannobile A, Galindo-Moreno P . Prognostic factors associated with implant loss, disease progression or favorable outcomes after peri-implantitis surgical therapy. Clin Implant Dent Relat Res. 2022; 24(2):222-232. DOI: 10.1111/cid.13074. View

19.

Isehed C, Svenson B, Lundberg P, Holmlund A . Surgical treatment of peri-implantitis using enamel matrix derivative, an RCT: 3- and 5-year follow-up. J Clin Periodontol. 2018; 45(6):744-753. DOI: 10.1111/jcpe.12894. View

20.

Brian Z, Weintraub J . Oral Health and COVID-19: Increasing the Need for Prevention and Access. Prev Chronic Dis. 2020; 17:E82. PMC: 7458118. DOI: 10.5888/pcd17.200266. View