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Decontamination and Repair Protocol Promotes Positive Outcomes in Peri-implantitis–Affected Implants: A Human Case Series

Marcos Ribeiro Sallé, DDS, MSc/Daniel Deluiz, DDS, PhD/Paul Fletcher, DDS/Monike F. Santoro, DDS, MSc/Eduardo M. B. Tinoco, DDS, PhD

DOI: 10.11607/prd.5534

This study assessed the effectiveness and predictability of a readily available protocol for the treatment of peri-implantitis using mechanical debridement, chemical antiseptic surface detoxification, and osseous grafting. Nine patients (seven female and two male, mean age: 56.5 years) with a total of 15 peri-implantitis–affected implants were selected for the trial. Pocket probing depth (PPD), bleeding on probing (BOP), and standardized digital periapical radiographs measurements were taken. Surgical flaps were elevated, and the implant threads were cleaned with a plastic curette. Chemical decontamination was performed by scrubbing solutions of 0.25% sodium hypochlorite (NaClO) and 1.5% hydrogen peroxide (H2O2) around the exposed implant using cotton pellets. Bone defects were filled with a 50/50 mixture of bovine hydroxyapatite and nanocrystalline calcium sulfate (CaSO4). A porcine collagen membrane was placed over the grafted bone defect. Follow-up appointments were scheduled for 1 week, 2 weeks, 3 months, 6 months, 9 months, and 1 year posttreatment. Clinical and radiographic parameters were assessed and compared. At baseline, PPD varied from 5 mm to 7.5 mm, with a mean PPD of 6 mm (± .7 mm). At the 12-month follow-up, PPD varied from 1.5 mm to 4.2 mm, with a mean PPD of 2.5 mm (± .8 mm). The mean PPD reduction of 3.6 mm (59.2%) was statistically significant (P < .001). The number of bleeding sites around each test implant decreased significantly from 4 to 0.4 sites between baseline and 12 months (P < .001). The mean radiographic bone loss decreased from 4.8 mm (± 1.3 mm) to 2.7 mm (± 1.2 mm; P < .001). The proposed method of mechanical decontamination, chemical detoxification, and bone regeneration is clinically effective and reproducible. Clinical peri-implant parameters, as well as radiographic bone levels, were improved and maintained their stability for 1 year using this peri-implantitis treatment protocol.

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