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Use of Human Perivascular Stem Cells for Bone Regeneration
Published on: May 25, 2012
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Guided bone regeneration improves defect fill and reconstructive outcomes in 3-wall peri-implantitis defects
Kelvin I Afrashtehfar1,2, Hayam A Alfallaj3,4, Eduardo Fernandez5,6
1Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland. kelvin.afrashtehfar@unibe.ch.
Evidence-Based Dentistry
|October 13, 2024
Summary
Guided bone regeneration (GBR) showed a trend towards better defect fill and higher treatment success in peri-implantitis cases compared to open flap debridement (OFD). Both treatments maintained clinical outcomes over 36 months.
Area of Science:
- Dental Implantology
- Periodontology
- Regenerative Medicine
Background:
- Peri-implantitis, a common complication of dental implants, can lead to bone loss and implant failure.
- Effective treatment strategies are crucial for managing peri-implantitis and preserving implant function.
- Guided bone regeneration (GBR) using bone grafts and membranes is a potential therapeutic approach for bony defects.
Purpose of the Study:
- To compare the long-term outcomes of GBR with open flap debridement (OFD) in treating peri-implantitis-related bony defects.
- To evaluate the efficacy of deproteinized bovine bone mineral (DBBM) and native bilayer collagen membrane (NBCM) in GBR for peri-implantitis.
- To assess radiographic defect fill, clinical parameters, and patient-reported outcomes over 36 months.
Main Methods:
- A multi-center, randomized clinical trial involving 66 patients with peri-implantitis.
- Patients were randomized to GBR (using DBBM and NBCM) or OFD (control) for bony defects with ≥3 osseous walls.
- Outcomes including radiographic defect fill, probing pocket depth, bleeding on probing, and patient-reported outcomes were assessed at baseline and 36 months.
Main Results:
- GBR showed a mean radiographic defect fill of 2.13 mm versus 1.64 mm for OFD at 36 months (p=0.18).
- Treatment success rates were 46.2% for GBR and 20% for OFD (p=0.053).
- No significant differences were observed in probing pocket depth, bleeding on probing, suppuration, mucosal recession, or patient-reported outcomes between the groups.
Conclusions:
- GBR demonstrated a trend towards improved defect fill and higher treatment success compared to OFD in peri-implantitis cases, though not statistically significant.
- Both GBR and OFD maintained clinical parameters and patient satisfaction over 36 months.
- The adjunctive use of DBBM and NBCM in GBR may offer benefits for specific peri-implantitis defect morphologies.
