Alveolar Bone Reconstruction Simultaneous to Implant Removal due to Advanced Peri-Implantitis Defects: A Proof of Concept.

Objective: To evaluate the safety and effectiveness of alveolar bone reconstruction simultaneous to implant removal due to peri-implantitis.

Material and methods: Partial or fully dentulous patients subjected to implant removal due to advanced peri-implantitis (≥ 50% of bone loss) lesions and seeking to have the failed implant replaced for esthetic or functional reasons were consecutively included. Guided bone regeneration was performed by means of a mixture of xenograft and autogenous bone and a ribose cross-linked barrier membrane. Re-entry for implant placement was performed at 4-month follow-up. Overall, six radiographic variables were assessed before (T0) and after (T1) alveolar bone reconstruction at four levels in ridge width (RW) and height (RH). Peri-implant conditions were evaluated at latest follow-up. Simple and multiple binary logistic regression models were calculated using generalized estimation equations to evaluate the effect of baseline upon reconstructive outcomes.

Results: In total, 20 patients (n_implant = 39) met the inclusion criteria. Alveolar RW and RH were augmented from T0 to T1 at all levels. All implants achieved primary stability. Only ~13% were subjected to ancillary bone regeneration simultaneous to implant placement. After a mean follow-up period after loading of ~2.2 years, ~70% implants demonstrated peri-implant health, while mucositis was diagnosed in the remaining implants.

Conclusion: The performance of alveolar bone reconstruction in residual partially contained defects simultaneous to implant removal due to peri-implantitis lesions demonstrates being safe and effective for implant site development.