Five-year follow-up of a reconstructive surgical protocol for peri-implantitis: A retrospective study

Peri-implantitis therapy aims at overcoming peri-implant inflammation and preventing further marginal bone loss; however, the achievement of stable reconstructive outcomes remains challenging in non-contained defects. This retrospective study evaluated the 5-year effectiveness of reconstructive surgical protocol using a mixed graft composed of deproteinized bovine bone mineral and biphasic calcium sulfate in non-contained peri-implant defects around standard-length implants. Patients treated for peri-implantitis at a university clinic between January 2018 and June 2019 were retrospectively screened: 28 (32 implants) met the inclusion criteria (probing depth ≥5 mm with bleeding and/or suppuration on probing and radiographic bone loss ≥3 mm). Surgical treatment consisted in full-thickness flap elevation, implant surface decontamination using a standardized protocol, defect grafting, and non-submerged tension-free closure. Clinical and radiographic parameters were assessed at surgery, 3- and 5-year follow-up. Mean follow-up was 61.4 ± 8.5 months. Implant survival at 5 years was 100%. Implant-based treatment success was 75%, disease recurrence occurred in 25% of implants. Probing depth and clinical attachment level showed significant improvements from baseline to both follow-up time points (p < 0.001); radiographic analyses demonstrated significant defect fill and improvement in bone-related parameters (p ≤ 0.002). The proposed reconstructive approach provided stable results in the long-term for non-contained peri-implant defects.