Anti-infective surgical therapy of peri-implantitis. A 12-month prospective clinical study

Aim: The aim of this prospective cohort study was to evaluate an anti-infective surgical protocol for the treatment of peri-implantitis.

Materials and methods: Thirty-six implants in 24 partially dentate patients with moderate to advanced peri-implantitis were treated using an anti-infective surgical protocol incorporating open flap debridement and implant surface decontamination, with adjunctive systemic amoxicillin and metronidazole. Treatment outcomes were assessed at 3, 6 and 12 months. Patient-based statistical analyses using multiple regression analyses were performed.

Results: There was 100% survival of treated implants at 12 months. At 3 months, there were statistically significant (P < 0.01) reductions in mean probing depths (PD), Bleeding on Probing (BoP) and suppuration. The greater the mean PD at baseline, the greater the PD reduction at 3 months. At 3 months, there was also a significant mean facial mucosal recession of 1 mm (P < 0.001). All these changes were maintained at 6 and 12 months. At 12 months, all treated implants had a mean PD < 5 mm, while 47% of the implants had complete resolution of inflammation (BoP negative). At 12 months, 92% of implants had stable crestal bone levels or bone gain. There were no significant effects of smoking on any of the treatment outcomes.

Conclusions: For the treatment of peri-implantitis, an anti-infective protocol incorporating surgical access, implant surface decontamination and systemic antimicrobials followed by a strict postoperative protocol was effective at 3 months with the results maintained for up to 12 months after treatment.