Efficacy of implantoplasty in the treatment of peri-implantitis: A 24-month randomized controlled clinical trial

Abstract

MAIN: This study aimed to compare the efficacy of implantoplasty and mechanical therapy in the treatment of peri‑implantitis.

Methods: In this prospective, controlled, randomized, and blinded clinical trial, implants were randomly allocated into two groups: surgical access with mechanical debridement (control group) and surgical access with mechanical debridement combined with implantoplasty (test group). The primary and secondary outcomes were assessed at baseline, 3, 6, 12, and 24 months: Probing Depth (PD), Plaque Index (PI), Gingival Bleeding Index (GBI), Bleeding on Probing (BoP), and Keratinized Mucosal Width (KM). Quality of life was assessed using the Oral Health Impact Profile (OHIP-14).

Results: 13 individuals and 33 implants were included in this study (17 in the control group and 16 in the test group). The mean age of the participants was 60.6 years, and 69.2 % were female. Of the 33 implants, 17 received control therapy, and 16 received test therapy. Of all rehabilitations, 53.8 % were total, and 30.8 % were partial, with the remainder being unitary. Split-Plot ANOVA revealed a significant effect of time on all clinical variables, indicating a decrease in values over the follow-up periods (p < 0.05). However, no significant interactions between time and treatment were observed. The OHIP-14 showed that, at baseline, there was a predominance of "Physical pain," "Psychological discomfort," and "Physical disability," while at 12 months, there was an improvement in the assessed items.

Conclusion: Evidence is insufficient to suggest that incorporation of implantoplasty improves clinical parameters during the surgical treatment of peri‑implantitis, compared to mechanical debridement alone.

Clinical significance: Implantoplasty is frequently performed during peri‑implantitis surgery, yet this study suggests it may offer no added benefit. Clinicians should reconsider its routine use, especially considering potential risks such as structural compromise and titanium particle release.

Keywords: Debridement; Dental implants; Peri-implantitis; Therapeutics.