Reconstruction of Peri-implant Osseous Defects: A Multicenter Randomized Trial

Area of Science:

• Dental Implantology
• Periodontology
• Regenerative Medicine

Background:

• Peri-implantitis poses a significant challenge in implant dentistry.
• Limited data exists on the effectiveness of reconstructive procedures for peri-implantitis osseous defects.

Purpose of the Study:

• To compare the effectiveness of open flap debridement (OFD) plus porous titanium granules (PTGs) versus OFD alone in reconstructing peri-implant osseous defects.

Main Methods:

• A multinational, multicenter randomized trial involving 63 patients with peri-implant intraosseous defects.
• Defects were treated with either OFD plus PTGs or OFD alone after surface decontamination.
• Radiographic defect fill and clinical parameters (probing depth, bleeding on probing) were assessed at 12 months.

Main Results:

• The OFD plus PTG group demonstrated significantly greater mean radiographic defect fill (3.6 mm) compared to the OFD group (1.1 mm) (P < 0.0001).
• Both groups showed comparable reductions in probing depth and bleeding on probing.
• Complete resolution of peri-implantitis occurred in 30% of the PTG group and 23% of the control group.

Conclusions:

• Reconstructive surgery with PTGs significantly enhances radiographic defect fill in peri-implantitis.
• While PTGs improve bone fill, clinical outcomes were similar between reconstructive and non-reconstructive surgical approaches.
• Further research is needed to verify new bone formation and differentiate it from biomaterial.