Marco Aurelio Bianchini
Several surgical therapies have been proposed to counteract peri-implantitis (PI) and stop the progression of peri-implant bone loss. Implantoplasty has been claimed as a promising strategy to treat peri-implant disease and prevent progressive bone loss. The aim of the present retrospective study is to evaluate the success rate and clinical outcomes of 23 peri-implantitis cases treated through a combined surgical resective/implantoplasty therapy applying a novel “platform switch” technique to preserve peri-implant tissues integrity and counteract progressive bone loss in a 2 year follow-up period. 23 patients who underwent dental implant therapy, were diagnosed with peri-implantitis, and were treated through access flap surgery, a modified implantoplasty applying a platform switch design, bone recontouring, and surface decontamination. Implantoplasty success rate was determined by radiographic and clinical parameters recorded before and over the 2-year follow-up. Marginal bone loss (MBL) as the primary endpoint, presence of suppuration, pain, mobility, and implant fracture were evaluated through clinical and radiographic analysis before(T0), after the surgical treatment(T1), and after 2-years follow-up(T2). The 2-year follow-up exhibited peri-implant bone stability in 21 cases (91.3%) showing radiographically a MBL reduction(mean) of 0.2mm/SD:0.1 (mesial) and 0.04mm/SD:0.1 (distal). 3(13%) treated implants showed radiographically a mesial bone gain of (1.6 /SD: 0.1mm). Only one implant showed progressive bone loss (4.3%) of 1.5mm (mesial) after the 24-month follow- up, however the implant did not show any other clinical signs or symptoms. One implant was lost after one year of treatment due to mobility, presenting a failure rate of 4.3%. Pain and suppuration were resolved in 22 cases (96%) and none of the cases reported implant fracture or mobility after the modified implantoplasty was performed. Considering there is no “gold standard” treatment for PI, the relevant 2-year follow-up success rate of combined surgical resective and novel “platform switch” implantoplasty therapy shows that this modified technique is promising since it counteracted progressive bone loss and eliminated PI signs and symptoms in more than 90% of the cases. Importantly, this therapy showed bone gain in smoothened surfaces in 13%, which is the desired goal of PI treatment. Consequently, further clinical studies are need to consolidate the efficiency and relevance of this novel technique for PI treatment.
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