Stability of peri-implantitis surgical reconstructive therapy-a (> 2 years) follow-up of a randomized clinical trial

Chin-Wei Wang; Riccardo Di Gianfilippo; Niko Kaciroti; Alice Ou; Sheng-Wei Feng; Hom-Lay Wang

doi:10.1007/s00784-023-05457-6

Stability of peri-implantitis surgical reconstructive therapy-a (> 2 years) follow-up of a randomized clinical trial

Clin Oral Investig. 2023 Dec 26;28(1):30. doi: 10.1007/s00784-023-05457-6.

Authors

Chin-Wei Wang^{1

2

3}, Riccardo Di Gianfilippo⁴, Niko Kaciroti⁵, Alice Ou⁴, Sheng-Wei Feng^{6

7}, Hom-Lay Wang⁴

Affiliations

¹ Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA. jeffwa@tmu.edu.tw.
² School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan. jeffwa@tmu.edu.tw.
³ Department of Dentistry, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan. jeffwa@tmu.edu.tw.
⁴ Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
⁵ Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA.
⁶ School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
⁷ Department of Dentistry, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.

PMID: 38147180
DOI: 10.1007/s00784-023-05457-6

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.

Keywords: Dental implants; Follow-up studies; Humans; Laser therapy; Peri-implantitis; Treatment outcome.

Publication types

Randomized Controlled Trial

MeSH terms

Dental Care
Follow-Up Studies
Humans
Image Processing, Computer-Assisted
Peri-Implantitis* / surgery
Plastic Surgery Procedures*

Associated data

ClinicalTrials.gov/NCT03127228

Abstract

Publication types

MeSH terms

Associated data

Grants and funding