"Surgical vs. Non-surgical Peri-implant Therapy"
Peri-Implantitis, Implant Complication, Bone Loss
About this trial
This is an interventional treatment trial for Peri-Implantitis focused on measuring peri-implantitis, non-surgical therapy, reconstructive therapy, bone graft
Eligibility Criteria
To take part in this study, patients must present at least one implant diagnosed with peri-implantitis [i.e., peri-implant bone level ≥ 3mm apical to the most coronal portion of the intraosseous part of the implant, peri-implant pocket depth (PPD) ≥ 6 mm, and presence of bleeding and/or suppuration on gentle probing (BOP/SOP) (Berglunh et al. 2018)
Inclusion Criteria:
- Men and women over 18 years old.
- Presence of ≥ 1 endosseous implants with clinical and radiographic signs of peri- implantitis [i.e., peri-implant bone level ≥ 3mm apical to the most coronal portion of the intraosseous part of the implant, PPD ≥ 6 mm, and presence of bleeding and/or suppuration on gentle probing (BOP/SOP).
- Implant function time ≥ 1 year.
- Vertical peri-implant bone defect (defects of 2-3 walls and a defect depth ≥ 3 mm).
- Presence of at least 2 mm of keratinized mucosa.
- Absence of active periodontal disease.
- Good level of oral hygiene (Plaque Index < 25%) (O'Leary et al. 1972)
- Screw-retained single-unit crowns and partial dental prosthesis that allowed correct access for brushing; and, if not,
- Prostheses that could be modified.
- Absence of occlusal overload.
Exclusion Criteria:
- Clinical implant mobility.
- Radiographic peri-implant bone loss > 50%.
- Pregnancy or lactating females.
- Any medical condition which contraindicated surgical peri-implant therapy.
- Previous non-surgical treatment (i.e., subgingival debridement) of the affected implants at least 12 months before.
- Previous surgical treatment of the affected implants.
- Systemic diseases, medications, or conditions that may compromise wound healing influencing the outcome of the therapy.
- Known allergy or intolerance to metronidazole or ibuprofeno.
- Use of systemic antibiotics during the previous 3 months.
- Use of systemic antibiotics for endocarditis prophylaxis.
- Smoking more than 10 cigarettes/day.
Sites / Locations
- Universitat Internacional de Catalunya (UIC)Recruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Test group (TG)
Control group (CG)
Patients will receive professional supragingival teeth/implant prophylaxis, oral hygiene instructions, and implant-supported prosthesis corrections if needed. After 1 week, peri-implant non-surgical therapy combined with antibiotic regimen consisting on metronidazole 500 mg every 8 hours for 7 days will be performed. Finally, the patients will be enrolled in a peri-implant maintenance therapy (PIMT) program every 3 months.
Patients will receive professional supragingival teeth/implant prophylaxis, oral hygiene instructions, and implant-supported prosthesis corrections if needed. After 1 week, peri-implant non-surgical therapy combined with antibiotic regimen consisting on metronidazole 500 mg every 8 hours for 7 days will be performed. After one month, the regenerative surgical therapy will be performed as it follows: the intrabony component of the defect will be filled with a xenograft and covered with a collagen membrane allowing a non-submerged healing. Finally, the patients will be enrolled in a PIMT program every 3 months.