Long Term Outcomes of Non-Surgical Treatment of Peri-Implantitis: A Retrospective Case Series.

Abstract

bjective: Conventional non-surgical techniques are considered ineffective for peri-implantitis management. The aim of this retrospective case series is to present the long-term results of a non-surgical protocol for peri-implantitis treatment, in a private practice setting.

Materials and methods: Peri-implantitis diagnosis criteria were presence of bleeding on probing with or without suppuration, probing pocket depth (PD) > 5 mm and interproximal radiographic bone loss (IBL)>2mm on a non-mobile implant. The treatment protocol included oral hygiene instruction, thorough implant instrumentation with ultrasonic tips and rotating titanium brushes, meticulous removal of granulation tissue, local or systemic antibiotics, possible prosthesis modification, long-term use of antimicrobials, and individualized supportive care. Clinical and radiographic parameters were recorded at initial visit and last follow-up.

Results: Twenty-six patients (30 implants) were included. Mean follow-up time was 86.1 months (range: 18-180 months). During follow-up, the protocol was repeated once in 10 implants and twice in another 10 implants. Four implants were explanted due to significant progressive bone loss. The remaining 26 stable/improved implants showed significant mean PD reduction (3.5 mm) and mean radiographic bone gain (1.9 mm), without PD>5 mm or further bone loss >0.5mm, resulting in 86.7% survival rate.

Conclusions: The presented non-surgical protocol provided stable long-term clinical and radiographic outcomes, demonstrating the possibility of maintaining dental implants treated for peri-implantitis in a practice setting. Retreatment over the years was necessary to achieve these results.