Surgical Treatmentofperi-Implantitis

Abstract

To assess the surgical treatment of choice of peri-implantitis, by evaluating clinical outcomes according to the approach. Materials and Methods: A bibliographic research is carried out by investigating several databases: PubMed, MEDLINE, Cochrane and Google Scholar. Articles have been selected according to defined inclusion criteria such as a ten-years range with relevant key words. Results and Discussion: 21 studies were included. Both non-augmentative and augmentative technique show good clinical and radiographic outcomes for treating peri-implantitis. Results from studies performing an access flap surgery combined with bone-recontouring report reductions of probing depth, bleeding on probing and suppuration with stable bone levels. Disease recovery usually occurs in the case of implants with slight bone loss. 13 studies assessing augmentative techniques report improvements in clinical and radiographic signs of peri-implantitis. Significant bone level gain and 2-3 mm reduction of probing depth can be achieved. Circumferential intrabony defect type displays greatest reductions of probing depth and clinical attachment loss. Two studies show higher reduction of probing depth and radiographic bone fill after regenerative treatment compared to non-augmentative one. Conclusion: Non-augmentative and augmentative procedures both may be effective technique to treat peri-implantitis. There is insufficient evidence to identify and conclude which is the surgery of choice. According to the defect morphology, resective surgery addresses supra-crestal bone defects, in none or minor esthetic aspects. Regenerative techniques are more prone to correct infra-osseous circumferential defects and retentive defects.