Treatment of peri-implantitis using guided bone regeneration and bone grafts, alone or in combination, in beagle...

The aim of this study was to histologically evaluate and compare the treatment of ligature-induced peri-implantitis using guided bone regeneration, two bone grafts alone, or guided bone regeneration combined with one of the two bone graft materials. Mandibular premolars and first molars in seven beagle dogs were extracted. After placement of Brånemark implants and connection of abutments, experimental peri-implantitis was induced. Flap surgery was performed, abutments were removed, and implant surfaces were treated with an air-powder abrasive unit. Bony defects were randomly treated with either (1) debridement only; (2) debridement plus resorbable hydroxyapatite; (3) debridement plus canine demineralized freeze-dried bone; (4) debridement plus guided bone regeneration; (5) debridement plus resorbable hydroxyapatite and guided bone regeneration; or (6) debridement plus canine demineralized freeze-dried bone and guided bone regeneration. Four months after surgery, a flap was elevated and the barriers were removed. One month later, the animals were sacrificed, and the implants with their supporting peri-implant tissues were processed for histologic evaluation. Guided bone regeneration procedures resulted in the greatest amount of new bone formation, followed by bone grafts alone, and flap debridement. There was no significant difference between guided bone regeneration and both guided bone regeneration/graft combinations in terms of bone regeneration; however, the guided bone regeneration/graft combinations resulted in a greater amount of "reosseointegration" than all of the other treatments. Therefore, the combination of guided bone regeneration with either demineralized freeze-dried bone or resorbable hydroxyapatite appears to be the treatment of choice for plaque-induced peri-implant defects.