Correction of Peri-Implant Buccal Bone Dehiscence Following Sub-Periosteal Peri-Implant Augmented Layer Technique...

To evaluate the effectiveness of Sub-periosteal Peri-implant Augmented Layer (SPAL) technique performed with deproteinized bovine bone mineral (DBBM), delivered either as particulate (pDBBM) or block (bDBBM), in correcting a peri implant bone dehiscence (PIBD). Implants showing a thick (≥ 2 mm) peri-implant buccal bone plate (PBBP) at placement were also examined.

Patients with a PIBD ≥ 1 mm, treated with SPAL with either pDBBM (SPAL_particulate) or bDBBM (SPAL_block), and patients with an implant showing a PBBP ≥ 2 mm at insertion (CONTROL) were included. Re-entry was performed either at 6 months (SPAL groups) or 3 months (CONTROL). The rate of patients presenting no PIBD at re-entry was the primary outcome. Bone dehiscence height (BDH) and width (BDW), thickness of buccal tissues (BTT) and marginal bone level (MBL) were secondary outcomes.

Thirty-nine implants in 39 patients (14 in SPAL_particulate,14 in SPAL_block and 11 in CONTROL) were analyzed. No PIBD were found in SPAL_particulate whereas in SPAL_block one PIBD was present. Two patients in CONTROL presented a PIBD. A reduction in both BDH and BDW was observed in both SPAL_particulate (2.7 ± 1.6 mm for BDH and 3.9 ± 0.2 mm for BDW) and SPAL_block (2.5 ± 1.8 mm for BDH and 3.8 ± 1.1 mm for BDW). SPAL_block showed a higher BTT than SPAL_particulate at re-entry (3.6 ± 1.3 mm for SPAL_block and 2.6 ± 0.6 mm for SPAL_particulate, p = 0.0160). All groups showed similar MBL.

SPAL performed with either a pDBBM or bDBBM is similarly effective in correcting a PIBD as well as in increasing BTT.