Surgical Therapy of Peri‐Implant Disease: A 3‐Year Follow‐Up Study of Cases Treated With 3 Different Techniques of Bone Regeneration

Abstract

Background: Advanced peri‐implant intrabony defects require comprehensive surgical treatment regimens different from periodontal therapy strategies. The purpose of this longitudinal trial was to evaluate the peri‐implant outcomes following guided bone regeneration with 3 treatment protocols.Methods: In 25 patients, 41 peri‐implant defects with supporting bone loss >50% of the implant length were treated with flap surgery plus autogenous bone grafts alone (FG) (controls, n = 12) plus non‐resorbable (FGM) (test 1, n = 20) or bioabsorbable barriers (FGRM) (test 2, n = 9) and supportive antimicrobial therapy. Following submerged healing, the membranes were removed (FGM), and the peri‐implant probing depths (PD), probing bone levels (BL), mobility scores (PT), and intrabony defect height (DH) were radiographically evaluated at baseline, 6 months, and 1 and 3 years post‐therapy.Results: Non‐surgical/anti‐infective therapy resulted in a limited improvement of PD scores after 6 months. At the 3‐year visit, surgical treatment revealed significant changes from baseline for the controls and both of the test groups for PD: 5.1 ± 2.7 mm (FG), 5.4 ± 3.0 mm (FGM), and 2.6 ± 1.6 mm (FGRM), and for BL: 3.2 ± 2.4 mm (FG), 3.4 ± 2.4 mm (FGM), and 2.3 ± 1.6 mm (FGRM), Mann‐Whitney test, P ≤0.05. The changes for DH and PT were significant only for FG‐ and FGM‐treated subjects. The overall improvement for FGRM‐treated patients during the 3‐year observation was less marked. However, the differences between the 3 surgical treatment protocols did not affect the treatment outcomes after 3 years.Conclusions: Autogenous bone grafting is an appropriate treatment regimen to augment open crater‐formed peri‐implant defects. Although certain clinical situations require an additional fixation of barrier membranes, their routine application should be approached with caution. J Periodontol 2001;72:1498‐1508.