Surgical reconstructive treatment for infraosseous peri-implantitis defects with a submerged healing approach: A prospective controlled study

Abstract

Background: The aim of this study was to assess the reconstructive potential of a submerged healing approach for the treatment of infraosseous peri-implantitis defects. Methods: Patients with a diagnosis of peri-implantitis were recruited. Implant suprastructures were removed before the surgical treatment, which included implant surface and defect detoxification using implantoplasty, air-power driven devices, and locally delivered antibiotics. The augmentation procedure included a composite bone graft and a non-resorbable membrane followed by primary wound coverage and a submerged healing of 8 months, at which point membranes were removed, and peri-implant defect measurements were obtained as the primary outcome. Secondary endpoints included assessment of cone-beam computed tomography (CBCT) and probing depth (PD) reductions. Results: Thirty implants in 22 patients were treated. A significant clinical bone gain of 3.22 ± 0.41 mm was observed at 8 months. Radiographic analysis also showed an average gain of 3.47 ± 0.41 mm. Three months after installment of new crowns, final PD measures showed a significant reduction compared to initial examinations and a significant reduction in bleeding on probing compared to examinations at the pre-surgical visit. Conclusions: Reconstruction of infraosseous peri-implantitis defects is feasible with thorough detoxification of implant sites, and a submerged regenerative healing approach.