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Table 3 Surgical and non-surgical experimental studies of dental implants following treatment of peri-implantitis

From: Management of peri-implantitis: a systematic review, 2010–2015

References

Diagnosis of peri-implantitis

No. of implant

Treatment strategy

Follow up

Study parameters

Results

Group 1

Goup 2

Schar et al. (2013)

PPD 4–6 mm

BOP

Bone loss—0.5–2 mm

No mobility

67

Photodynamic therapy

Minocycline Microspheres locally

6 months

BOP

CAL

PPD

Mucosal recession

Modified plaque index

Both treatment equally effective but no complete resolution of inflammation

Schwarz et al. (2006b)

PD 4 mm

BOP

Suppuration

No mobility

Keratinized peri-implant mucosa

12

Er:YAG laser

 

6 months

Plaque index

BOP

PD

Gingival recession

CAL

Histo-pathology

Improved clinical parameters

Mixed chronic inflammatory cell infiltrate

Renvert et al. (2006, 2008)

PD ≥4 mm

Bleeding/pus on probing

Bone loss ≤1.8 mm

Anaerobic bacteria

95

Minocycline microspheres locally 1 mg

1 % chlorhexidine gel

12 months

PD

BOP

Local plaque index

Bonel level

Bacterial count

Both treatment resulted marked reduction in indicator bacteria

Minocycline treatment improved PD

Persson et al. (2010)

PPD ≥4 mm

Bone loss >2.5 mm

Bleeding/pus on probing

Curettes

Ultrasonic device

6 months

PD

BOP

Bacterial count

Both methods failed to eliminate bacterial counts

Hallstrom et al. (2012)

PPD ≥4 mm

Bleeding/pus on probing

Non-surgical debridment

Systemic antibiotics

Non-surgical debridment

6 months

PD

BOP

Bacterial count

BOP and PPD were improved with antibiotic treatment

No changes in bacterial count in both groups

Sahm et al. (2011)

PPD ≥4 mm

Bone loss ≤30 %

Bleeding

Suppuration

No mobility

No occlusal overload

2 mm keratinized attached mucosa

Good PI

43

OHI (Oral Hygiene Instructions)

Amino acid glycine powder (AAD)

Mechanical debridement with carbon curettes

Antiseptic therapy chlorhexidine digluconate (MDA)

6 months

BOP

PD

CAL

Both groups revealed comparable PD reduction and CAL gains

Higher changes in BOP in AAD group

Renvert et al. (2011), and Persson et al. (2011)

PPD ≥5 mm

Bone loss ≥2 mm

BOP

100

Er:YAG laser

Air-abrasive device

6 months

PPD

BOP

Bacterial counts

Both method showed limited clinical improvement but failed to reduce bacterial count.

Karring et al. (2005)

PPD ≥5 mm

Bone loss ≥1.5 mm

BOP

Vector® system

Submucosal debridment with carbon fiber curette

6 months

Plaque

BOP

PPD

Bone level

There was no significant difference between the two methods although BOP was reduced in Vector® system

Machtei et al. (2012)

PD 6–10 mm

BOP

Bone loss

77

Implant debridement

Matrix chips (MatrixC)

Implant debridement

Chlorhexidine chips (PerioC)

6 months

BOP

PD

CAL

PerioC showed greater clinical improvement than MatrixC

Aghazadeh et al. (2012)

PD ≥5 mm

BOP

Bone loss ≥3 mm

Suppuration

Mucosal recession

75

Resection surgery

Autogenous bone

Collagen membrane

Antibiotic

Resection surgery

Bovine derived xenograft (BDX)

Collagen membrane

Antibiotic

12 months

PD

BOP

Suppuration

Bone loss

BDX with collagen membrane showed more radiographic bone defect fill

Bothe treatment offered improvement in BOP, PD and suppuration

Schwarz et al. (2008, 2009)

PD >6 mm

Bone loss >3 mm

Keratinized mucosa

22

Access flap surgery

Hydroxy-apatite nanocrystals

Access flap surgery

Natural bone mineral

Collagen membrane

24 months and 4 years

Plaque

BOP

PPD

Bone level

Attachment loss

Natural bone plus membrane offered better result

Schwarz et al. (2006a)

PD >6 mm

Bone loss >3 mm

Keratinized mucosa

22

Access flap surgery

Hydroxy-apatite nanocrystals

Access flap surgery

Bovine derived xenograft

Collagen membrane

6 months

Plaque

BOP

PPD

Bone level

Attachment loss

Both treatment offered PD reduction and CAL gain

Wohlfart et al. (2012)

PD ≥5 mm

Bone loss ≥4 mm

BOP

32

Resective surgery using titanium curettes

24 % ethylenediaminetetraacetic acid

Resective surgery using titanium curettes

Porous titanium granules (PTG)

12 months

PPD

Bone level

BOP

Reconstruction with PTG resulted better radiographic peri-implant defect fill

Romeo et al. (2007)

PD ≥4 mm

Bleeding

Suppuration

No implant mobility

Radiographic horizontal peri-implant radiolucency

38

Amoxicillin 50 mg/kg prior to treatment for 8 days

Implantoplasty

Amoxicillin50 mg/kg prior to treatment for 8 days

Resective surgery

3 Years

Marginal bone loss

Radiographs revealed implantoplasty as an effective treatment

Schwarz et al. (2011, 2012)

PD >6 mm

Intrabony defect >3 mm-

2 mm Keratinized mucosa

26 and 38

Resective surgery

Implantoplasty

Er:YAG laser in intra bony components

Natural bone Mineral

Collagen membrane

Resective surgery

Implantoplasty

Cotton pellets dipped in sterile saline (CPS)

Natural bone mineral

Collagen membrane

6 and 24 months

BOP

Attachment loss

Bone loss

24 months treatments with CPS offered better clinical parameters as well as bony defect fill

de Waal et al. (2013)

PD ≥5 mm

Bone defect ≥2 mm

Bleeding

Suppuration

79

Resective surgery with apically repositioned flap

Bone recountouring

Surface debridment/decontamination

0.12 % chlorhexidine

0.05 % cetylpyrinidium chloride (CPC)

Placebo

12 months

BOP

Suppuration

PD

Bacterial count

CHX + CCP treatment results immediate suppression of bacterial count

  1. PPD periodontal pocket depth, PD pocket depth, BOP bleeding on probing, CAL clinical attachment loss