Surgical treatment of peri-implantitis: 3-year results from a randomized controlled clinical trial

Abstract

Objectives: This study reports on the 3-year follow-up of patients enrolled in a randomized controlled clinical trial on surgical treatment of advanced peri-implantitis.

Material and methods: A total of 100 patients with advanced peri-implantitis were randomly assigned to one of four treatment groups. Surgical therapy aiming at pocket elimination was performed and, in three test groups, supplemented by either systemic antibiotics, use of an antiseptic agent for implant surface decontamination or both. Outcomes were evaluated after 1 and 3 years by means of clinical and radiological examinations. Differences between groups were explored by regression analysis.

Results: Clinical examinations at 3 years after treatment revealed (i) improved peri-implant soft tissue health with a mean reduction in probing depth of 2.7 mm and a reduction in bleeding/suppuration on probing of 40% and (ii) stable peri-implant marginal bone levels (mean bone loss during follow-up: 0.04 mm). Implant surface characteristics had a significant impact on 3-year outcomes, in favour of implants with non-modified surfaces. Benefits of systemic antibiotics were limited to implants with modified surfaces and to the first year of follow-up.

Conclusion: It is suggested that surgical treatment of peri-implantitis is effective and that outcomes of therapy are affected by implant surface characteristics. Potential benefits of systemic antibiotics are not sustained over 3 years.

Keywords: dental implant; implant surface characteristics; surgical treatment.