Evaluation of Peri-Implantitis Bone Defect Healing: Comparing the Efficacy of Small-Particle Dentin and Bio-Oss in Bone Density Attenuation

Abstract

Introduction: Peri-implantitis is a serious complication in dental implantology that, if left untreated, may lead to implant loss and systemic diseases. Effective regeneration of bone defects resulting from peri-implantitis is crucial to maintaining the functionality of dental implants. Purpose of the Study: The study aimed to compare the effectiveness of fine-particle dentin and Bio-Oss in the reconstruction of bone defects caused by peri-implantitis. Materials and Methods: The study included a comprehensive radiological assessment of changes in bone density over time. Bone density was assessed using Hounsfield Units (HUs) as a measure of bone attenuation, with radiological assessments performed at 8- and 12-week intervals during the healing process. The study included participants ranging in age from 30 to 65 years. Fifty-seven patients were divided into three groups: 22 patients received small-particle dentin, 15 received Bio-Oss, and 20 controls without bone substitute material. Results: The fine-dentin group showed a 20% increase in bone density after 8 weeks (p < 0.05), while the Bio-Oss group showed a 15% increase after 12 weeks (p < 0.05). The control group showed minimal changes in bone density (5% after 12 weeks), which was not statistically significant. Clinical evaluations showed 95% successful integration in the fine dentin group, 85% in the Bio-Oss group, and 70% in the control group. The fine-dentin group showed a 20% increase in bone density after 8 weeks (p < 0.05), while the Bio-Oss group showed a 15% increase after 12 weeks (p < 0.05). The control group showed minimal changes in bone density (5% after 12 weeks), which was not statistically significant. Clinical evaluations showed 95% successful integration in the fine-dentin group, 85% in the Bio-Oss group, and 70% in the control group. Conclusions: Both fine-particle dentin and Bio-Oss significantly improved bone density compared to the control group. Fine-particle dentin is suitable for immediate bone regeneration due to its rapid initial regeneration, while Bio-Oss provides long-term support, ideal for maintaining implant stability over a longer period of time. The results highlight the importance of selecting appropriate bone replacement materials depending on the clinical scenario to improve patient outcomes after dental implant placement.

Keywords: Bio-Oss; bone regeneration; bone substitute materials; periimplantitis; small-particle dentin.

Figure 1

Classification and assessment of the morphology of bone defects associated with peri-implantitis. (A) Radiographic description of bone defects associated with peri-implantitis subosseous defect (Class I); (B) radiographic description of bone defects associated with peri-implantitis horizontal defect (Class II); (C) radiographic description of bone defects associated with peri-implantitis complex defect (Class III); (D) panoramic radiograph of a patient illustrating the presence of Class III bone defects around all implanted dental implants.

Figure 2

The most commonly used bone substitute materials. (A) Xenograft material; (B) barrier membrane; (C) impacted tooth before processing procedure; (D) obtained small-particle dentin; (E) comparison of autogenous bone chips and xenograft material.

Figure 3

Illustrative photo of the materials used. (A) Obtained bone substitute material from the tissues of the processed tooth; (B) material of xenogeneic origin—BioOss.

Figure 4

ROI measurement.

Figure 5

Images showing the defect resulting from periimplantitis: (A) clinical photo, (B) radiographic photo, (C) photo after defect restoration with bone substitute material.