Surgical Reconstructive Peri-Implantitis Treatment for 3- and 4-Wall Bone Defects: A Single-Blind Randomised Controlled Trial With a 1-Year Follow-Up.

Abstract

AIM To evaluate the effect of a reconstructive procedure during surgical treatment of peri-implantitis in 3- or 4-wall bone defects on clinical and radiographic outcomes after 1 year follow-up. MATERIALS AND METHODS Fifty-two patients with peri-implantitis were randomly assigned to surgical treatment with (n = 27) or without (n = 25) a reconstructive procedure using autologous bone, xenograft and a collagen membrane. Primary outcomes were the mean peri-implant probing depth (PPD) and radiographic marginal bone level (MBL). Bleeding on probing (BoP) was the prespecified primary outcome in the original protocol; the present report emphasises PPD and MBL outcomes relevant to reconstructive treatment. Secondary outcomes included BoP, disease resolution (composite treatment outcome), suppuration (SoP), mid-buccal recession (Midbuc REC) and keratinised mucosa (Midbuc KM). Data were analysed using multilevel mixed-effects models. RESULTS Mixed-effects models showed that patients in the test group showed enhanced marginal bone levels at all follow-ups (β = -0.85 to -1.65 mm; p ≤ 0.04) and less mid-buccal recession (β = -1.06 to -1.68 mm; p ≤ 0.01) compared to the control group. No significant differences were observed for PPD, BoP, SoP, Midbuc KM or disease resolution. CONCLUSION While the adjunctive reconstructive procedure did not significantly influence peri-implant PPD, BoP, SoP or disease resolution, it was associated with improved radiographic marginal bone levels and reduced mid-buccal soft-tissue recession.